CAUSE OF ANEMIA

1. Introduction

In general, the high prevalence of anemia is caused by bebe bro factors including low iron
intake and other nutrients such as vitamin A, C, folate, riboplafin and B12 to meet iron requirements
in a day it can be done by consuming food sources animal as one source of iron that is easily
absorbed, consume vegetable food sources which are sources of substance iron ones high but difficult
to absorb ( Briawan, 2014)

The main factor causing anemia is lack of iron intake. About two-thirds of iron in the body is
found in hemoglobin red blood cells. Other factors that influence the incidence of anemia include
lifestyle such as smoking, drinking alcohol, breakfast habits, socio-economic and demographic,
education, gender, u-mur and region. Urban or rural areas are influential through mechanisms related
to the availability of health facilities and the availability of food which in turn affects the health
service and iron intake.

Iron is crucial to biologic functions, including respiration, energy production, DNA synthesis,
and cell proliferation.2 The human body has evolved to conserve iron in several ways, including the
recycling of iron after the breakdown of red cells and the retention of iron in the absence of an
excretion mechanism. How-ever, since excess levels of iron can be toxic, its absorption is limited to 1
to 2 mg daily, and most of the iron needed daily (about 25 mg per day) is provided through recycling
by macrophages that phagocytose senescent erythrocytes. The latter two mechanisms are controlled
by the hormone hepcidin, which maintains total-body iron within normal ranges, avoiding both iron
deficiency and excess.

Iron deficiency affects more than 2 billion people worldwide,1 and iron-deficiency anemia
remains the top cause of anemia, as confirmed by the analysis of a large number of reports on the
burden of disease in 187 countries between 1990 and 201014 and by a survey on the burden of ane-
mia in persons at risk, such as preschool chil-dren and young women. Prevention programs have
decreased rates of iron-deficiency anemia globally; the prevalence is now highest in Cen-tral and
West Africa and South Asia. The esti-mated prevalence of iron deficiency worldwide is twice as high
as that of iron-deficiency anemia.

The reported prevalence of iron deficiency in the absence of dietary fortification is approxi-
mately 40% in preschool children, 30% in men-struating girls and women, and 38% in pregnant
women.These rates reflect the increased physiological need for dietary iron during spe-cific life stages
and according to sex. The growth spurt of adolescence is another critical period. For patients in any of
these categories, pathologic causes of iron-deficiency anemia are often absent and extensive
diagnostic workups are not advised. However, as discussed below, when the response to treatment is
unsatisfacto-ry, multiple causes should be considered, even in patients in these high-risk groups.

2. Case Report

The reported prevalence of iron deficiency in the absence of dietary fortification is approxi-
mately 40% in preschool children, 30% in men-struating girls and women, and 38% in pregnant
women.14-16 These rates reflect the increased physiological need for dietary iron during spe-cific life
stages and according to sex. The growth spurt of adolescence is another critical period. For patients in
any of these categories, pathologic causes of iron-deficiency anemia are often absent and extensive
diagnostic workups are not advised. However, as discussed below, when the response to treatment is
unsatisfactory, multiple causes should be considered, even in patients in these high-risk groups.
 The 2001 SKRT morbidity study collected data on risk factors that included routine habits,
alcoholic beverages, morning habits, use of time for physical activities, results of anthropometric
measurements and hemoglobin levels.

3. Discuss

Among Southeast Asian countries, Indonesia is listed as one of the countries with a large
number of anemia sufferers. According to data from the 2013 Basic Health Research (Riskesdas), the
number of anemia sufferers in Indonesia consisted of 26.4 percent of children, 12.4 percent of men
aged 13-18 years, 16.6 percent of men over 15 year, 22.7 percent of women aged 13-18 years, 22.7
percent of women aged 15-49 years, and 37.1 percent of pregnant women.

In general the causes of anemia are:

Vitamin deficiency
Lack of vitamin B12 and folate deficiency can result from lack of food also in certain
autoimmune conditions. Because pernicious anemia is the most common cause of vitamin B12
deficiency in the UK. Because pernicious anemia is an autoimmune condition. This means the
immune system attacks the body's own cells. Usually Vitamin B12 is absorbed using a protein called
intrinsic factor that is attached to the vitamin B12 diet and allows it to be absorbed from the stomach.
Because pernicious anemia leads to destruction of this intrinsic factor by the immune system. Lack of
vitamin B12 and folate is seen commonly in pregnant women and in the elderly

Iron Deficiency
Foods that are low in iron can cause anemia. Iron derived from vegetables and supplements are
not absorbed well as iron in red meat. Digestive problems such as Crohn's disease, Celiac, or even the
result of undergoing gastric bypass surgery can also interfere with iron absorption. Some foods and
medicines also can inhibit iron absorption. Like milk, other foods that contain calcium, calcium
supplements, antacids, coffee, and tea. So avoid these foods when you want to increase your body's
iron levels.

Chronic disease
Chronic diseases or infections can cause the body to make fewer red blood cells. This can result
in a mild decrease in hemoglobin. If you have significant blood loss, you can suffer from anemia.
There are also several medications and medical treatment can also be at risk of anemia. Consult your
doctor to see if you need iron or other supplements.

Increased Erythrocytes
Increased erythrocyte destruction, for example in diseases: immune system disorders,
thalassemia.

Decrease in Erythrocyte Production

Decreased erythrocyte production, for example in aplastic anemia, lacks nutrition

Large blood loss

For example due to acute bleeding, chronic bleeding, menstruation, chronic ulcer and trauma

3. Conclusion

Hepcidin is the key regulator of iron homeo-stasis.3 The body has no proven means to modu-
late iron excretion; its iron content is controlled through modulation of iron acquisition and stor-age.
In patients with iron deficiency, iron absorp-tion is increased, as is the release of iron from
macrophages. When the iron level is high, absorp-tion decreases and the release of iron from mac-
rophages is inhibited. Hepcidin regulates these adaptive processes by controlling the surface ex-
pression of the iron export protein ferroportin (FPN1 [also known as SLC40A1]) on duodenal en-
terocytes and on iron-recycling macrophages. Hepcidin binds ferroportin, leading to the phos-

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