ANEMIA

-one of the more common blood disorders, occurs when the level of healthy red blood cells
(RBCs) in the body becomes too low. This can lead to health problems because RBCs contain
hemoglobin, which carries oxygen to the body's tissues. Anemia can cause a variety of
complications, including fatigue and stress on bodily organs.

Three main bodily mechanisms that produce anemia:

1. Excessive destruction of RBCs

2. Blood loss

3. Inadequate production of RBCs

Anemia Caused by Destruction of RBCs

Hemolytic anemia-occurs when red blood cells are being destroyed prematurely. (The normal
lifespan of RBCs is 120 days; in hemolytic anemia, it's much shorter.) And the bone marrow (the
soft, spongy tissue inside bones that makes new blood cells) simply can't keep up with the body's
demand for new cells. This can happen for a variety of reasons. Sometimes, infections or certain
medications — such as antibiotics or anti seizure medicines — are to blame.

In autoimmune hemolytic anemia-the immune system mistakes RBCs for foreign invaders and
begins destroying them. Other kids inherit defects in the red blood cells that lead to anemia;
common forms of inherited hemolytic anemia include sickle cell anemia, thalassemia, glucose-6-
phosphate dehydrogenase (G6PD) deficiency, and hereditary spherocytosis.

• Sickle cell anemia-a severe form of anemia found most commonly in people of African
heritage, although it can affect those of Caucasian, Saudi Arabian, Indian, and
Mediterranean descent. In this condition, the hemoglobin forms long rods when it gives
up its oxygen, stretching red blood cells into abnormal sickle shapes. This leads to
premature destruction of RBCs, chronically low levels of hemoglobin, and recurring
episodes of pain, as well as problems that can affect virtually every other organ system in
the body. About 1 out of every 625 African-American children is born with this form of
anemia.
• Thalassemia-which usually affects people of Mediterranean, African, and Southeast
Asian descent, is marked by abnormal and short-lived RBCs. Thalassemia major, also
called Cooley's anemia, is a severe form of anemia in which RBCs are rapidly destroyed
and iron is deposited in the skin and vital organs. Thalassemia minor involves only mild
anemia and minimal red blood cell changes.

• Glucose-6-phosphate dehydrogenase (G6PD) deficiency-most commonly affects males

of African heritage, although it has been found in many other groups of people.
 • Hereditary spherocytosis-genetic disorder of the RBC's membrane that can cause
anemia,jaundice (yellow-tinged skin), and enlargement of the spleen.

Anemia Caused by Blood Loss

• Blood loss can also cause anemia — whether it's because of excessive bleeding due to
injury, surgery, or a problem with the blood's clotting ability. Slower, long-term blood
loss,

such as intestinal bleeding from inflammatory bowel disease (IBD), can also cause
anemia. Anemia sometimes results from heavy menstrual periods in teen girls and
women. Any of these factors will also increase the body's need for iron because iron is
needed to make new RBCs.

Anemia Caused by Inadequate Production of RBCs

• Aplastic anemia

-occurs when the bone marrow can't make enough RBCs. This can be due to a
viral infection, or exposure to certain toxic chemicals, radiation, or medications
(such as antibiotics, antiseizure drugs, or cancer treatments). Some childhood
cancers can also cause aplastic anemia, as can certain chronic diseases that affect
the ability of the bone marrow to make blood cells.

• physiologic anemia of infancy

-High levels of hemoglobin and RBCs help fetal blood carry enough oxygen to
developing babies in the relatively oxygen-poor environment in utero. After the
child is born, more oxygen is available and the baby's hemoglobin level normally
drops to a low point at about 2 months of age

• iron deficiency anemia

-most common cause of anemia in kids. Iron deficiency anemia can affect kids at
any age, but is most common in those younger than 2 years old. Young children
who drink excessive amounts of milk are at increased risk for iron deficiency.

- Poor dietary iron intake (or excessive loss of iron from the body)

Signs and Symptoms:

1. Irritability

2. Fatigue

3. Dizziness, lightheadedness, and a rapid heartbeat

Diagnostic tests:

• Blood smear examination: Blood is smeared on a glass slide for microscopic

examination of RBCs, which can sometimes indicate the cause of the anemia.

• Iron tests: These include total serum iron and ferritin tests, which can help to determine
whether anemia is due to iron deficiency.
• Hemoglobin electrophoresis: Used to identify various abnormal hemoglobins in the
blood and to diagnose sickle cell anemia, the thalassemias, and other inherited forms of
anemia.
• Bone marrow aspiration and biopsy: This test can help determine whether cell
production is happening normally in the bone marrow. It's the only way to diagnose
aplastic anemia definitively and is also used if a disease affecting the bone marrow (such
as leukemia) could be causing of the anemia.
• Reticulocyte count: A measure of young RBCs, this helps to determine if RBC
production is at normal levels.

Preventing Anemia

• Cow's milk consumption

• Iron-fortified cereal and formula
• Well-balanced diet.