Deficiency of qualitative and quantitative hemoglobin content in blood.
Based on Etiology
- Haemolytic anaemia
- Impaired RBC production and maturation:
- Iron deficiency
- Anemia due to vitamin B12, folic deficiency.
- Aplastic anaemia
- Sickle cell anaemia.
- Anemia of chronic disease (refractory anaemia)
Based on RBC morphology
Normocytic: (MCV: 76 96 fl MCHC 30-35g / dl)
- Acute bloood loss
- Anemia of chronic disease,
Macrocytic : (MCV> 96 fl MCHC 30-35 g di)
- Vitamin B 12 and folic acid deficiency
Microcytic : (MCV<76 fl MCHC<30G g/dl)
- Iron deficiency anaemia.
IRON DEFICIENCY ANAEMIA
– Low iron diet
– In presence of wheat eggs soyabean
– Chronic decease.
– children 6 months to 2 years
– Females of child bearing age
– External hemorrhage
– peptic ulcer
– Portal hypertension
Excessive iron loss:
– Exfoliative dematitis
- Onset: insidious
- Precordial pain (angina pectoris)
- Pain in abdomen.
- Aain in abdomen
- Sense of fullness after meals,
- Hair loss
- Numbness, tingling
- Lack of concentration
- Loss of Weight.
On general examination:
- Skin: pale, Dry, Lustrelress
- Hair: Thin, Lustreless.
- Nails: Brittle, Platynychia, Koilonychia
- Oedema : Bilateral, Pitting
- Angular Stomatitis
- Tongue: Smooth, bald, pale.
- Pulse: rapid
- Blood pressure: low
On cardiac examination :Soft systolic murmur at apex
On abdominal examination : Spleen may be palpable (Plummer- vinson syndrome)
Chronic iron deficiency anemia associated with:
- Hb%: variably reduced.
- RBC count: low
- Colour index: less than
- MCV: low (50-80 fl)
- MCH: low (15-26 pg)
- MCHC: low(24-30 g/dl)
- Peripheral smear
– Serum iron: low (<60mg/dl) - Iron binding capacity: increased (>400 mg dl)
– Plasma ferritin : low (< 10 mg/ml) Bone marrow
- Normoblastic hyperplasia
- frequent malformed cells
- haemoglobinistiion deficientin proportion to nuclear maturity.
- Microthromboblasts numerous in severe cases.
- Ova of ankylostoma may be positive.
- Amoebic cysts (amoebic colitis).
- Voluminous fatty stools (malasorption).
- Occult blood (upper gastro-intestinal bleeding).
- For evidence of peptic ulcer
For cvidence of : Haemorrhoids, Malignancy
Urinalysis : For haematuria.
Prognsis : Severity of anemia reflects activity of underly ing cause
- Anemia is not a disease but a manifstation of anunderlying disease.
- Miasmatic analysis is done according to cause
- If nutritional pseudo miasmatic disease.
- To cure
- to correct cause
- to remove obstruction to recovery
- Correct and treat the underlying cause: ie menorrhagia in womene gastrointestinal blood loss in age groups including hookworm in fastation dietary deficiency and rarely malab sorption.
- provide diet rich in iron and proteins.
- Blood transfusion if haemoglobin is less then 4g%
- Iron preparation not to be taken along with meals containing wheat eggs and soyabean(as these interfere with iron absorption)
– Aletris Farinosa
– Avena sativa
– Calcrea Phosphora
– Ferrum Mentallicum
– Arsenicum Album
– Ferrum Phosphoricum
– Menstrual Derangements
– Ferrum Metallicum
– Natrum Muriaticum
– Carbon Tetrachloride
– Supplementary Therapy Indications
– Nutritional iron deficiency other causes where iron deficiency can occur are pregnancy lactation, infants children.}
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