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Anemia

Anemia (American English) or anaemia (Commonwealth English), which literally means "without blood," is a deficiency of red blood cells and/or hemoglobin. This results in a reduced ability of blood to transfer oxygen to the tissues, and this causes hypoxia; since all human cells depend on oxygen for survival, varying degrees of anemia can have a wide range of clinical consequences. Hemoglobin (the oxygen-carrying protein in the red blood cells) has to be present to ensure adequate oxygenation of all body tissues and organs. more...

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The three main classes of anemia include excessive blood loss (acutely such as a hemorrhage or chronically through low-volume loss), excessive red blood cell destruction (hemolysis) or deficient red blood cell production. In menstruating women, dietary iron deficiency is a common cause of deficient red blood cell production.

Anemia is the most common disorder of the blood. There are several kinds of anemia, produced by a variety of underlying causes. Anemia can be classified in a variety of ways, based on the morphology of RBCs, underlying etiologic mechanisms, discernible clinical spectra, to mention a few.

Different clinicians approach anemia in different ways; two major approaches of classifying anemias include the "kinetic" approach which involves evaluating production, destruction and loss, and the "morphologic" approach which groups anemia by red blood cell size. (Schier) The morphologic approach uses as its starting point a quickly available and cheap lab test as its starting point (the MCV--see below). On the other hand, focusing early on the question of production (e.g., via the reticulocyte count) may allow the clinician to more rapidly expose cases where multiple causes of anemia may coexist. Regardless of one's philosophy about the classification of anemia, however, methodical clinical evaluation should yield equally good results.

Signs and symptoms

Anemia goes undetected in many people, and symptoms can be vague. Most commonly, people with anemia report a feeling of weakness or fatigue. People with more severe anemia sometimes report shortness of breath. Very severe anemia prompts the body to compensate by markedly increasing cardiac output, leading to palpitations and sweatiness; this process can lead to heart failure in elderly people.

Pallor (pale skin and mucosal linings) is only notable in cases of severe anemia, and is therefore not a reliable sign.

Diagnosis

The only way to definitively diagnose most cases of anemia is with a blood test. Generally, clinicians order a full blood count. Apart from reporting the number of red blood cells and the hemoglobin level, the automatic counters also measure the size of the red blood cells by flow cytometry, which is an important tool in distinguishing between the causes of anemia. A visual examination of a blood smear can also be helpful in some cases, and is sometimes a necessity in regions of the world where automated analysis is less accessible.

In modern counters, 4 parameters (RBC Count, hemoglobin concentration, MCV and RDW) are measured, allowing others (hematocrit, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration) to be calculated, and compared to values adjusted for age and sex. For males, the hemoglobin level that is suggestive of anemia is usually less than 13.0 g/dl, and for females, it is 12.0 g/dl.

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A new way to fight sickle-cell anemia
From Essence, 10/1/05 by Jeannine Amber

When you have a baby, you can also save someone's life. For years doctors have known that the blood present in the umbilical cord and placenta--tissues that are routinely discarded--are rich in stem cells.

These cells, the building blocks of tissue, can be used to treat more than 70 illnesses, including leukemia and sickle-cell anemia, a genetic disease that primarily strikes Black people.

Until recently, families who wanted to save their babies' cord blood for private use would pay for-profit storage firms about $900 to $1,800 plus annual fees; anti-stern-cell politics had made it difficult for public banks to flourish. But this past May, the House of Representatives passed a bill to fund public banks, expand inventory, and coordinate access to the blood. (At press time a Senate vote is pending.) "Many Black kids who suffer from sickle cell may go to doctors who don't know much about cord blood," says bill cosponsor Rep. Artur Davis (D-AL).

"This legislation will help doctors point patients to available units of the blood." FOR MORE INFORMATION: Visit nationalcordbloodprogram.org, the Web site of the New York Blood Center's public registry, and marrow.org, a site run by the National Marrow Donor Program, which also oversees a public cord-blood network.

COPYRIGHT 2005 Essence Communications, Inc.
COPYRIGHT 2005 Gale Group

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