Hematology || Red Blood Cell Anemia

Hello everyone, it's good to have you here again. Over the past days, I have been discussing Hematology, looking into the Formation of Red Blood Cell, the Lifecycle of Red Blood Cell, and Blood Typing. In today's post, I will be explaining extensively, Anemia.

Epidemiology of Anemia

Anemia is the inability of the blood to carry enough oxygen to the tissues in the body, or you can say it is the low amount of red blood cells in the blood. According to the article Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries, Anemia affects a third of the world's population, and a study showed that 56.55% of patients in an Australian hospital had anemia. In low income countries, Anemia has a 2 to 5 times prevalence rate, more than the United States..

Iron Deficiency Anemia

The Red Blood is made of Hemoglobin, which carries oxygen to around the body. Hemoglobin is made up of four heme molecules, made up of Iron (Fe), which allows for the binding of oxygen. When there is a deficiency in the amount of iron in the red blood cell, thereby leading to the lack of oxygen in the blood, it is referred to as Iron Deficiency Anemia. According to the article Iron Deficiency Anemia, which was updated in August 2021, Iron Deficiency Anemia is the most common type of Anemia resulting in microcytic and hypochromic red cells on a peripheral smear. Iron deficiency anemia is responsible for 50% of all types of Anemias, and it is common in productive women compared to men..

Iron deficiency Anemia could occur as a result of decreased intake of iron, impaired absorption of iron, increased loss of iron, and Increase demand of iron. Decreased intake could be as a result of low intake of iron rich food, as well as impaired absorption of iron even when eating iron rich food. Iron deficiency Anemia could occur as a result of intravascular hemolysis or during hemorrhage, such as during menstruation or menorrhagia, where there is much blood loss but less blood production or iron production in the blood, others could include bleeding from any part of the body with less blood to replace or iron to replace the loss iron. The final one would be increased demand in iron, compared to its production. Cases such as pregnancy could lead to the increase in demand..

People who suffer from Iron deficiency Anemia would have symptoms such as shortness of breath (Dyspnea), Fatigue, Increase Heart Workload (Tachycardia), dizziness, and Weakness . The Mycrocytosis in the red blood cell can be identified via blood tests such as, Mean Corpuscular Volume (MCV) where there is a low MCV, Low Mean Corpuscular Hemoglobin (MCH), and an increase in the Red Blood Cell Distribution Width..

The treatment for Iron deficiency Anemia would basically be taking more iron supplements orally and administration of Intravenous iron, treating the underlying sickness of iron deficiency, in severe cases, transfusion of Red blood cell.

Pernicious Anemia

When your body is unable to absorb Vitamin B12 caused by an autoimmune process where Intrinsic factor isn't produced in the Gastric mucosa of the stomach. . When the Intrinsic factor and B12 cannot bind, as a result of antibodies binding to the intrinsic factor, causing the body not to be able to absorb B12, In my post Erythropoiesis - The Formation of Red Blood Cell (Erythrocytes), I explained that B12 is needed for the Erythroblast to Mature, and when the red blood cell can't mature, it means the Red Blood Cell cannot Condense, causing Macrocytosis (huge red blood cell). When the red blood cell doesn't mature, they cannot carry oxygen, and they can become stuck in capillaries as a result of their size, causing hemolysis..

Symptoms would include Diarrhea, constipation, Shortness of breath, Jaundice, Dementia, and Delusions, and so on. Treatment can be through Intramuscular injections of B12, treating using approved sublingual and intranasal B12.

Hereditary Spherocytosis

In my post Erythropoiesis - The Life Cycle of The Red Blood Cell (Erythrocyte), I explained the Erythrocyte Membrane Model, which consist of the spectrin tetramer, Ankyrin, and the band-3 protein. This anemia occurs when the protein are inadequately produced in the red blood cell, causing the cell membrane to be rigid, and not form a bi-concave shape, thereby forming a spherical shape and leading to the death of the red blood cell earlier than the normal time. Due to spherocytosis, the red blood cell can pass through the spleen, and it is destroyed by the spleen before the 120 days lifespan.. This could lead to Spontaneous hemolytic crises, Splenomegaly, Spherocytosis, Skin ulcer, Reticulocytosis, and Restrictive cardiomyopathy.

Glucose 6-Phosphate Dehydrogenase (G6PDH) Deficiency

This is as a result of a defect, which leads to indequate production of the enzyme Glucose 6-Phosphate Dehydrogenase in the red blood cell, which leads to the breakdown of red blood cell prematurely as a result of the red blood cell being less permeable, and less flexible. This is the most common enzyme deficiency in humans, which has affected over 400 million people around the world.. This leads to hemolysis of the Red Blood Cell. It is a genetic deficiency, which can be transferred from parent to offspring. Treating the underlying disease which causes the deficiency will be able to treat the G6PDH deficiency.

Sickle Cell Anemia (HDS)

General explanation of Sickle Cell Anemia is when the red blood cell takes the shape of a sickle/crescent. It is the replacement of the 6th amino acid in the β-globin chain, which is glutamine acid to Valine, thereby causing the red blood cell hemoglobin molecule to polymerize when there is no oxygen being bonded. The repeated sickling of the cell membrane will lead to decreased elasticity of the cell membrane and damaging of the cell membrane.. Sickle cell red blood cell could stick in places causing crisis such as Priapism, Splenomegaly. Sickle Cell Anemia is being treated by blood transfusion, help increase the oxygen in the blood, and Opioid for pain..

Hemorrhagic Anemia

This is as a result of blood loss, which lead to loss of red blood cells, which would in turn leads to a decrease in red blood cell and the ability of the blood to carry oxygen, causing Anemia.. This could be an internal or external Hemorrhage, internally, disease such as peptic ulcer could lead to bleeding in the stomach, Aorta aneurysm, and so on could lead to Hemorrhagic Anemia.. In treating Hemorrhagic Anemia, treating the underlying cause of the anemia would be helpful. Other teatment includes blood transfusions, plasmapheresis, or diuresis.

Aplastic Anemia

This anemia occurs due to the destruction of the bone marrow. If you remember in my previous post on Erythropoiesis, I explained that the Heamocytblast in the bone marrow forms the Myeloid stem cells, and Lymphoid Stem cell, where the Myeloid cell forms the Red Blood cell, White Blood Cells and the Blood Platelet. In Aplastic Anemia, the Myeloid stem cells are destroyed.. Leading to low Red Blood Cells (Anemia), low White Blood Cell (leukopenia), and Low Platelet (Thrombocytopenia).. Treatment is ussually a bone marrow transplant, and Stem Cell Stimulation.

Conclusion

The Red Blood Cell is responsible to transferring oxygen to the body, as well as transporting carbon(di)oxide to the lungs. The make up of the red blood cell makes it readily available to transport oxygen, and when this doesn't occur, it leads to anemia. Some anemia can be genetic, some can be as a result of environmental causes, and others are Latrogenic

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