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ANEMIAS
DESCRIPTION CRITERIA CLINICAL CLASSIFICATION ANEMIAS SPECIALIST TO CONSULT

DEFINITION

The decrease is of laó a hemoglobin concentration in blood. This parameter is not a fixed value but it depends on several such factors like age, sex and such certain special circumstances like the pregnancy.

DIAGNOSTIC CRITERIA

According to the WHO it is accepted that anemia exists when the hemoglobin concentration in blood is lower than the following values:

Children from 6 months until 6 years 11 gr./dl
Children from 6 to 14 years 12 gr./dl
Adult males 13 gr./dl
Adult, not pregnant woman 12 gr./dl
Adult, pregnant woman 11 gr./dl

CLASSIFICATION

The anemia can stem from different causes and these are related very well to the changes of form and size of the Red Globules (G.R). This size is different according to the producing cause of the anemia. The size of the G.R. is determined by an analytical parameter called Average Corpuscular Volume (VCM) and that it allows to classify to the anemias in:

A) Anemia microcítica (VCM <80 fl)

  • Anemia ferropénica. For lack of iron
  • Hemoglobinopatías: Talasemia minor.
  • Secondary anemia to chronic illness.
  • Anemia sideroblástica.

B) Anemia normocítica (VCM 80 - 100 fl)

  • Anemias hemolíticas.
  • Fundamental Aplasia.
  • Fundamental invasion.
  • Secondary anemia to chronic illness.
  • Bled sharp.

C) Anemia macrocítica (VCM> 100 fl)

  • 1) HEMATOLÓGICAS.
  • Anemias megaloblásticas.
  • Anemias aplásicas.
  • Anemias hemolíticas. (Crisis reticulocitaria).
  • Syndromes mielodisplásicos.
  • 2) NOT HEMATOLÓGICAS.
  • Abuse completed alcohol.
  • Chronic Hepatopatía.
  • Hipotiroidismo.
  • Hipoxia.

CLINIC

The anemia produces in the organism a series of disorders of general type that do not coincide with a concrete illness and that might be summed up in the following table:

  • General declarations.
  • Weariness.
  • Decrease of the sexual desire.
  • Declarations cardio - circulatory.
  • Palpitations.
  • It tires after the effort.
  • Tension goes down.
  • Inflammation in the ankles.
  • Neurological declarations.
  • Headache.
  • Sickness, dizziness.
  • Drowsiness, confusion, irritability.
  • Noises in the ears.
  • Gynecological declarations.
  • Menstrual alterations.
  • Declarations in the skin.
  • Paleness.
  • Fragility in the fingernails.
  • Alopecia.
  • In serious and/or sharp cases.
  • Cold and humid skin.
  • Decrease of the volume of urine.
  • Pain in the breast (ángor).
  • Other symptoms and specific signs according to the type of anemia and/or causal factor.

DESCRIPTION OF THE PRINCIPAL ANEMIAS

ANEMIAS FERROPÉNICAS:

It is a question of an anemia for lack of iron. This absence of iron can be caused for:

  • Increase of the blood losses:
    • Abundant rule, bled digestive, blood in urine, etc.
  • Increase of the needs:
    • There are passing circumstances in which the organism needs a major iron contribution and, nevertheless, this one does not increase in the diet: Pregnancy, lactation, growth etc.
  • Decrease in the intestinal absorption:
    • Produced of stomach, diarrhea and other illnesses of the digestive tract.
  • Scarce feeding:
    • Milk without supplements, diet poor in proteins (meat, caught etc.).

TALASEMIAS (Hemoglobinopatías)

It is a form of caused anemia because the hemoglobin is defective and, therefore, it does not fulfill his function that is that of transporting the oxygen. It is a hereditary illness and it owes to a genetic disorder.

SECONDARY ANEMIA TO CHRONIC ILLNESS

The anemia is provoked by a preexisting illness of chronic type at digestive, renal level, etc.

ANEMIA HEMOLÍTICA

It is the produced one by an immune disorder that gives like turned out the creation of cells similar to the Red Globules that compete with these, well destroying them or supplanting his function.

Examples: Transfusions of not compatible blood, poisonous substances, etc.

FUNDAMENTAL APLASIA

Disorder of the marrow that causes an alteration in the process of formation of the Red Globules doing that these present immature forms and have, therefore, his shaken function.

ANEMIA MEGALOBLÁSTICA

It takes place for the absence of one or two of the elements that intervene in the formation of the Red Globules: the acid fólico and the vitamin B12.

As in the previous case, the absence of these elements is caused well by a deficit of the food that possess them or for a loss due to digestive disorders.

WHEN TO COME TO THE SPECIALIST

URGENT DERIVATION.

  • In case of sharp anemia.

    • Any sharp anemia with circulatory alterations.
    • Anemia for bled sharp with difficulty for the control of the hemorrhage and/or that needs treatment of transfusion (Htc <25 %; Hb <7 - 8 g/dl).
    • Clinic of sharp crisis of hemólisis.

  • In case of chronic anemia.

    • Bad clinical tolerance and/or haemodynamics for sharpening of the base illness or for factors of worsening (in general they tolerate well numbers of low Hb of the order of 7 - 8 g/dl).

NOT URGENT, BUT IT MUST GO TO THE SPECIALIST

  • Anemias microcíticas.
    • Anemias sideroblásticas.
    • Anemia for chronic illness of not clarified and/or friendly origin in the Primary health care level.
  • Anemias normocíticas.
    • Any anemia hemolítica.
    • Any anemia with suspicion of affectation of bone marrow. (Affectation of more than one cellular series hematológica).
    • Anemia for chronic illness of not clarified and/or not friendly cause in the Primary health care level.
  • Anemias macrocíticas.
    • Anemia megaloblástica for study etiológico and beginning of specific treatment. Any anemia with suspicion of affectation of bone marrow. (Affectation of more than one cellular series hematológica).

WHAT DOCTOR CAN TREAT ME?

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Writing: Medical equipment   Update: June, 2009
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