Anaemia results from a lack of red blood cells or dysfunctional red blood cells in the body. This leads to reduced oxygen flow to the body's organs. Symptoms may include fatigue, skin pallor, shortness of breath, lightheadness, dizziness or a fast heartbeat. Treatment depends on the underlying diagnosis. Iron supplements may be used for iron deficiency. Vitamin B supplements maybe used for low vitamin levels. Blood transfusions may be used for blood loss. Medications to induce blood formation may be used if the body’s blood production is reduced.

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INTRODUCTION
 Anemia is the most common nutritional deficiency disorder
in the world.
 Anemia is a major killer in India. As it affects an estimated
50% of the population.
 Statistics reveal that every second Indian woman is anemic.
 One in every five maternal deaths is directly due to anemia.
 Anemia affects both adults and children of both sexes, although
pregnant women and adolescent girls are most susceptible and
most affected by this disease.
 Anemia prevalence in young children continues to remain
over 70% in most parts of India.

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OBJECTIVES
What is Anemia?
Classification and Pathophysiology of Anemia
Anemia Cause
Anemia Symptoms
Lab Investigation of Anemia
Treatment
What Is Anemia?

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Anemia is a conditionthat develops when your blood lacks enough healthy re
d blood cells or hemoglobin.Hemoglobin is a main part of red blood cells and
binds oxygen. If you have too few or abnormal red blood cells, or your
hemoglobinis abnormal or low, the cells in your body will not get enough
oxygen.
Symptoms of anemia -- like fatigue -- occur because organs aren't getting
what they need to function properly.
Anemia is the most common blood conditionin the U.S. and India. It affects
about 3.5 million Americans.Women, young children, and people with
chronic diseases are at increased risk of anemia. Important factors to
remember are:
 Certain forms of anemia are hereditary and infants may be affected
from the timeof birth.
 Women in the childbearing years are particularly susceptibleto iron-
deficiency anemia because of the blood loss from menstruation and the
increased blood supply demands during pregnancy.
 Older adults also may have a greater risk of developing anemia because
of poor diet and other medical conditions.
PATHOPHYSIOLOGY

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CLASSIFICATION
TYPES OF ANAEMIA

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 Normochromic, normocytic anaemia (normal MCHC,
normal MCV).These include:
◦ Anemia of chronic disease
◦ Haemolytic anemia (those characterized by accelerated
destruction of rbc's)
◦ Anemia of acute hemorrhage
◦ Aplastic anemia (those characterized by disappearance
of rbc precursors from the marrow)
 Hypochromic, microcytic anaemia (low MCHC, low
MCV).Theseinclude:
◦ Iron deficiency anemia
◦ Thalassemia
◦ Anemia of chronic diseases
 Normochromic, macrocytic anaemia(normal MCHC, high
MCV).Theseinclude:

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◦ Vitamin B12 deficiency
◦ Folate deficiency
CAUSES OF ANAEMIA
Based on clinical picture-

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 Iron deficiency anaemia
♣ Excessive loss of iron.
♣ Women are at risk. ---- For menstrual blood and
growing fetus.
Megaloblastic anaemia
♣ Less intake of vitamin B 12 and folic acid.
♣ Red bone marrow produces abnormal RBC.
E.g. cancer drugs
Pernicious anaemia
♣ Inability of stomach to absorb vitamin B 12 in small
intestine.
 Hemorrhagic anaemia
♣ Excessive loss of RBC through bleeding, stomach ulcers,
menstruation

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Hemolytic anaemia
♣ RBC plasma membraneruptures.
♣ May be due to parasites, toxins, antibodies.
 Thalassemia
♣ Less synthesis of hemoglobin .Found in population of
Mediterranean sea.
 Sickle cell anemia
♣ Hereditary blood disorder, characterized by red blood
cells that assume an abnormal, rigid, sickle shape.
Aplastic anaemia
♣ Destruction of red bone marrow.
♣ caused by toxins, gamma radiation.
SIGNS AND SYMPTOMS
Common symptoms of anemia
Easy fatigue and loss of energy

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Unusually rapid heartbeat, particularly with exercise
Shortness of breath and headache, particularly with
exercise
Difficulty concentrating
Dizziness
Pale skin
Leg cramps
Insomnia
AnaemiaCaused by Iron Deficiency
People with an iron deficiency may experience these symptoms:

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 A hunger for strange substances such as paper, ice, or dirt
(a condition called pica)
 Upward curvature of the nails, referred to as koilonychias
 Soreness of the mouth with cracks at the corners
AnaemiaCaused by Vitamin B12 Deficiency
People whose Anemia is caused by a deficiency of Vitamin B12
may have these symptoms:
 A tingling, "pins and needles" sensation in the hands or feet
 Lost sense of touch
 A wobbly gait and difficulty walking
 Clumsiness and stiffness of the arms and legs
 Dementia
 Hallucinations, paranoia, and schizophrenia

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Symptoms of anemia

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Investigations
The red cell population is defined by
1. Quantitative parameters:
 Volume of packed cells i.e. the haematocrit
 Hemoglobin concentration
 Red cell concentration per unit volume.
2. Qualitative parameters:
 Mean corpuscular volume
 Mean corpuscular hemoglobin
 Mean corpuscular hemoglobin concentration.

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Quantitativeparameters
 Haematocrit (Packed cell volume): It is the proportion of
the volume of blood sample that is occupied by RBCs.
 Men -42-52%
 Women -36-48%
 Cell Volume Hemoglobin Concentration: It is the amount
of hemoglobin per unit volume of blood.(Gms/Dl)
 Women - 12-16gms/dl
 Men - 14-17 Gms/dl
 Red Cell Count: Total number of Red Cells per unit
volume of blood sample. [ No. of RBC/ cu.mm ]
 Men - 4.2-5.4*106//mm3
 Women- 3.6-5.0* 106/mm3

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Qualitativeparameters
 Mean Corpuscular Volume: It is the average volume a
RBC. [ fL ]
 Normal 82-98mm3or 82-98fL
 Mean Corpuscular Hemoglobin: It is the average
hemoglobin content per RBC.
 Normal value is 27 to 31 pL
 Mean Corpuscular Hemoglobin Concentration: It is the
average concentration of hemoglobin in a given Red Cell
Volume. [Gms/ dL ]
 Normal 32-36 g/Dl

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TREATMENT
MILD &MODERATE
GROUP DOSAGE/day
Children2-5 years 20-30mg iron
Children6-11 years 30-60mg iron
Adolescentsandadults 60 mg iron
 Anaemia will correct within 2 to 4 months if appropriate
iron dosages are administered and underlying cause of iron
deficiency is corrected.
 Continue iron therapy an additional 4 to 6 months (adults)
after the hemoglobin normalizes to replenish the iron stores.

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SEVERE ANAEMIA
 After completing 3 months of therapeutic
supplementation, pregnant women and infants should
continue preventive supplementation program.
AGE GROUP DOSE DURATION
<2 years 25 mg iron + 100-
400 ug folicacid
daily
3 months
2-12 years 60 mg iron + 400 ug
folicaciddaily
3 months
Adolescentsand
adults, including
pregnantwomen
120 mg iron+400ug
folicaciddaily
3 months