Anaemia is a condition where the blood lacks enough healthy red blood cells or haemoglobin, leading to reduced oxygen delivery to the body's tissues. This can result in symptoms like fatigue, weakness, shortness of breath and pale or yellowish skin. The severity of anaemia can vary from mild to severe and may affect individuals of all ages.
Anaemia can be classified based on its underlying causes, which are generally grouped into three categories:
Iron deficiency anaemia: This is the most common type and occurs when your body doesn't have enough iron to produce haemoglobin. It can result from poor diet, chronic blood loss (such as heavy periods or ulcers) or certain chronic diseases.
Vitamin deficiency anaemia: This type occurs when the body lacks essential vitamins like B12 or folate, which are crucial for producing red blood cells. For example, pernicious anaemia is caused by the body's inability to absorb vitamin B12 properly.
Anaemia of chronic disease: Chronic illnesses such as kidney disease or chronic infections can impair the body's ability to produce enough red blood cells.
Haemolytic anaemia: Occurs when red blood cells are destroyed faster than the bone marrow can replace them. Causes include autoimmune diseases, inherited disorders like sickle cell anaemia or reactions to certain medications.
Sickle cell anaemia: A genetic disorder where red blood cells are abnormally shaped, causing blockages in blood flow, pain and other complications.
Acute blood loss anaemia: Results from a sudden and significant blood loss, such as from injury or surgery, leading to a rapid decrease in red blood cells.
Chronic blood loss anaemia: Results from long-term, slow bleeding, often due to conditions like ulcers or heavy menstrual periods, which gradually deplete the body's iron stores.
Anaemia often presents with a variety of symptoms, which can differ depending on the severity and underlying cause of the condition. Common symptoms include:
Anaemia can arise from a range of causes, typically grouped into:
Several factors can increase the risk of developing anaemia, including:
Dietary deficiencies: Inadequate intake of iron, vitamin B12 or folate can lead to anaemia, particularly in individuals with poor dietary habits or restricted diets.
Chronic conditions: People with chronic diseases such as kidney disease, cancer, diabetes or inflammatory conditions are at higher risk of anaemia due to the impact these conditions have on red blood cell production.
Family history: Inherited conditions like sickle cell anaemia or thalassemia can run in families, increasing the likelihood of developing anaemia.
Age and gender: Women, particularly those with heavy menstrual periods and older adults are more prone to anaemia. Pregnancy also increases the risk due to increased iron demands.
Lifestyle factors: Excessive alcohol consumption can interfere with red blood cell production, while smoking can reduce oxygen delivery to tissues, potentially exacerbating anaemia.
Diagnosing anaemia involves several laboratory tests that provide valuable insights for physicians. One of the primary tools is a blood smear, where a sample of blood is examined under a microscope. This allows the clinician to assess the shape, size and colour of red blood cells, identifying any abnormalities.
These confirmatory tests may also include a genetic study for certain hereditary disorders, biochemical determination of certain intracellular/extracellular chemical levels such as iron/folate, CT scan of the spleen for possible splenic disorders, bone marrow/lymph node biopsy for malignancies, etc. These features can offer critical clues, such as the presence of abnormal intracellular inclusions, parasites or other irregularities.
Based on these findings, additional tests may be necessary to confirm the diagnosis and determine the underlying cause. These may include:
Genetic testing: To detect hereditary disorders such as sickle cell anaemia or thalassemia.
Biochemical tests: To measure levels of iron, folate, vitamin B12 and other chemicals within the cells and bloodstream.
Imaging: A CT scan may be performed to evaluate the spleen, especially in cases where splenic disorders are suspected.
Bone marrow or lymph node biopsy: These tests are used to investigate potential malignancies or bone marrow disorders.
The treatment for anaemia is tailored to address its underlying cause. A haematologist will evaluate the patient to determine the specific cause of the anaemia and recommend appropriate treatment options. Depending on the diagnosis, the following treatments may be considered:
For anaemia due to blood cancers such as leukemias, myelomas, lymphomas or myelodysplastic syndrome, dedicated teams in the blood cancer service will assess and plan treatment with chemotherapy, immunotherapy or haematopoietic stem cell transplant as needed.
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