Anemia is the difficulty or decrease in the transport of oxygen to the rest of the tissues through the red blood cells. Symptoms may include fatigue, headache or joint pain. However, not all anemias are the same and the main objective is to find out what causes them and the possible underlying diseases.
What is anemia
Anemia, as we know it today, is not a disease in itself, but rather a syndromic set of signs and symptoms under which it will be necessary to investigate whether there is a disease causing them.
However, anemia is defined as the difficulty or decrease in the transport of oxygen by the red blood cells to the rest of the body’s tissues.
Symptoms of anemia
The main symptom of anemia, according to hematology experts, is fatigue. Other patients also report headache, joint discomfort, blurred vision and, a traditional symptom, especially in children, although it is seen less and less frequently (because it is mostly anemia that is allowed to evolve for a long time) is the appetite for the wall cast, which is called “Pica”.
On the other hand, although it all depends on the original cause of anemia, we find:
– pallor
– excessive hair loss
– brittle nails (when the underlying cause of anemia is a vitamin deficiency)
– increased heart and/or respiratory rate
– drop in blood pressure
– yellowing of the skin and/or mucous membranes (jaundice)
– enlargement of the liver or spleen
Are all anemias the same?
Not all anemias are the same. They can be classified in many ways.
One classification is from the epidemiological point of view. Thus, some anemias are more frequent in pediatric age, others in adulthood and others in old age. In fact, even during the physiological period of pregnancy there are more prevalent anemic processes.
Another classification is according to origin:
– Anemia of central or arregenerative origin: if it occurs due to a defect in erythrocyte manufacture in the bone marrow, which is the factory where all the cells we find in the blood are generated.
– Hemolytic anemia: due to excess destruction in the bloodstream.
Another way to classify anemia is according to the size of the red blood cell, measured by a laboratory parameter called mean corpuscular volume. Thus, we have:
– Microcytic anemias, which produce small red blood cells and cause iron deficiency.
– Normocytic anemias, which have normal-sized red blood cells and are anemia resulting from chronic disease.
– Macrocytic anemia, with increased erythrocyte size, is an anemia derived from vitamin B12 deficiency, alcoholism, liver disease…
As we can see, there are many systemic diseases that underlie the generation of an anemic process. Hematology is a specialty that correlates with other clinical and surgical specialties.
Diagnosis of anemia and underlying disease
The study of any anemia must be thoughtful, careful and systematized. It often involves the interaction of several specialists. Everything involves carrying out a good study of anemia where clinical data of the patient’s family and personal history, physical examination and an adequate study of complementary tests are collected. By means of these tests, the specialist will rule out processes and pathologies until the origin of the anemia is found and the appropriate treatment is applied.
A myth that we must avoid, and one that many of us physicians make a mistake with, is to consider that a patient is anemic when the red blood cell count is low. Nothing could be further from the truth, since there are anemic processes that occur with erythrocyte counts well above normal.
The laboratory parameter that confirms whether or not anemia is present is the hemoglobin level in the blood or hematocrit. This is the protein that stains the red blood cell this color and is responsible for transporting oxygen to the rest of the body’s organs.
Are all anemias treated with iron?
This is another idea that we should forget. Depending on the cause of the anemia, it is treated in one way or another. We must not forget that there are anemic processes that occur with high levels of iron deposition in the body.