Anaemia: haemolytic Health Dictionary

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Anaemia: Haemolytic: From 1 Different Sources

A blood condition due to abnormal destruction of red blood cells in the spleen.

Causes: hereditary background with deficiency of cell enzymes or cell membrane weakness; wrongly matched blood transfusion, environmental chemicals, food additives, colourings, drugs, infections. Symptoms. Pale face, sore tongue, headache, dizziness, palpitations, breathlessness, angina, weakness, loss of weight and appetite, jaundice (yellow skin), feverishness, vague aches and pains, enlarged spleen and pain under left ribs.

Treatment. Under hospital supervision.

Echinacea has a long reputation for regeneration of red blood cells: experience shows it beneficial for this type of anaemia. To assist control of symptoms: Gentian, Motherwort, Mugwort, Barberry, Hops, Saw Palmetto.

Bitter herbs stimulate the stomach, liver and pancreas. By increasing the appetite they benefit digestion and are given half an hour before meals by tea or decoction: Hops, Quassia chips, Angostura, Feverfew, Bogbean.

Formula. Tea. Milk Thistle 2; Betony 1; Hops 1. Mix. 1-2 teaspoon to each cup boiling water. Infuse 5-15 minutes. 1 cup, thrice daily.

Decoction. Echinacea 1; Sarsaparilla 1; Peruvian bark half; Saw Palmetto half. Mix. 2 teaspoons to 2 cups water, simmer gently 20 minutes. Half a cup, cold, thrice daily before meals.

For weak heart add one part Hawthorn; neurasthenia (Ginkgo); swelling of ankles (Lily of the Valley); loss of hormonal balance (Ginseng).

Prognosis. Surgical removal of spleen may be necessary.

Diet. Dandelion coffee, molasses, desiccated or fresh calves’ liver. Green leafy vegetables, dried beans, apricots. Shellfish, milk, eggs, Soya, meats. Supplements. Daily. Vitamin B12 1mg; Vitamin C, 1g; Folic acid 400mcg; Floradix.

Health Source: Bartrams Encyclopedia of Herbal Medicine
Author: Health Encyclopedia

Anaemia

Lack of enough blood in the body causing paleness... anaemia

Haemolytic Disease Of The Newborn

A potentially serious disease of the newborn, characterised by haemolytic ANAEMIA (excessive destruction of red blood cells) and JAUNDICE. If severe, it may be obvious before birth because the baby becomes very oedematous (see OEDEMA) and develops heart failure – so-called hydrops fetalis. It may ?rst present on the ?rst day of life as jaundice and anaemia. The disease is due to blood-group incompatibility between the mother and baby, the commoneset being rhesus incompatibility (see BLOOD GROUPS). In this condition a rhesus-negative mother has been previously sensitised to produce rhesus antibodies, either by the delivery of a rhesus-positive baby, a miscarriage or a mismatched blood transfusion. These antibodies cross over into the fetal circulation and attack red blood cells which cause HAEMOLYSIS.

Treatment In severely affected fetuses, a fetal blood transfusion may be required and/or the baby may be delivered early for further treatment. Mild cases may need observation only, or the reduction of jaundice by phototherapy alone (treatment with light, involving the use of sunlight, non-visible ULTRAVIOLET light, visible blue light, or LASER).

Whatever the case, the infant’s serum BILIRUBIN – the bilirubin present in the blood – and its HAEMOGLOBIN concentration are plotted regularly so that treatment can be given before levels likely to cause brain damage occur. Safe bilirubin concentrations depend on the maturity and age of the baby, so reference charts are used.

High bilirubin concentrations may be treated with phototherapy; extra ?uid is given to prevent dehydration and to improve bilirubin excretion by shortening the gut transit time. Severe jaundice and anaemia may require exchange TRANSFUSION by removing the baby’s blood (usually 10 millilitres at a time) and replacing it with rhesus-negative fresh bank blood. Haemolytic disease of the newborn secondary to rhesus incompatibility has become less common since the introduction of anti-D (Rho) immunoglobulin. This antibody should be given to all rhesus-negative women at any risk of a fetomaternal transfusion, to prevent them from mounting an antibody response. Anti-D is given routinely to rhesus-negative mothers after the birth of a rhesus-positive baby, but doctors should also give it after threatened abortions, antepartum haemorrhages, miscarriages, and terminations of pregnancy.

Occasionally haemolytic disease is caused by ABO incompatibility or that of rarer blood groups.... haemolytic disease of the newborn

Pernicious Anaemia

An autoimmune disease in which sensitised lymphocytes (see LYMPHOCYTE) destroy the parietal cells of the STOMACH. These cells normally produce intrinsic factor, which is the carrier protein for vitamin B12 that permits its absorption in the terminal ileum. Without intrinsic factor, vitamin B12 cannot be absorbed and this gives rise to a macrocytic ANAEMIA. The skin and mucosa become pale and the tongue smooth and atrophic. A peripheral NEUROPATHY is often present, causing paraesthesiae (see under TOUCH), numbness and even ATAXIA. The more severe neurological complication of sub-acute combined degeneration of the cord is fortunately more rare. The anaemia gets its name from the fact that before the discovery of vitamin B12 it was uniformly fatal. Now a monthly injection of vitamin B12 is all that is required to keep the patient healthy.... pernicious anaemia

Haemolytic Uraemic Syndrome

A disease of children resulting in acute RENAL failure. A febrile illness of the gastrointestinal or respiratory tracts is followed by intravascular COAGULATION of blood which results in HAEMOLYSIS, ANAEMIA, THROMBOCYTOPAENIA and renal failure (resulting from ?brin deposition in renal arterioles and glomerular capillaries).

The death rate is 2–10 per cent and the majority of patients survive without renal failure. The longer the period of OLIGURIA, the greater the risk of chronic renal failure.

Treatment is supportive, with replacement of blood and clotting factors, control of HYPERTENSION, and careful observation of ?uid balance.... haemolytic uraemic syndrome

Haemolytic

A herb that lyses red blood cells by causing them to rupture. Soapwort. ... haemolytic

Aplastic Anaemia

See anaemia, aplastic.... aplastic anaemia

Cooley’s Anaemia

See thalassaemia.... cooley’s anaemia

Fanconi’s Anaemia

A rare type of aplastic anaemia characterized by severely reduced production of all types of blood cells by the bone marrow.... fanconi’s anaemia

Cooley’s Anaemia

See THALASSAEMIA.... cooley’s anaemia

Microcytic Hypochromic Anaemia

corresponds to a large extent with what used to be known as ‘secondary anaemia’. It takes its name from the characteristic changes in the blood.... microcytic hypochromic anaemia

Anaemia: Sports

A side-effect of hard training in endurance sports with low haemoglobin and haematocrit levels due to rapid depletion of iron on excessive exertion. See: IRON DEFICIENCY ANAEMIA. ... anaemia: sports

Anaemia, Pernicious

See anaemia, megaloblastic.... anaemia, pernicious

Haemolytic Anaemia

See anaemia, haemolytic.... haemolytic anaemia

Haemolytic–uraemic Syndrome

A rare disease in which red blood cells are destroyed prematurely and the kidneys are damaged, causing acute kidney failure. Thrombocytopenia can also occur. Haemolytic–uraemic syndrome most commonly affects young children and may be triggered by a serious bacterial or viral infection. Symptoms include weakness, lethargy, and a reduction in the volume of urine. Seizures may occur. Blood and urine tests can determine the degree of kidney damage. Dialysis may be needed until the kidneys have recovered. Most patients recover normal renal function.... haemolytic–uraemic syndrome

Anaemia: Aplastic

Failure of the bone marrow to produce red cells because of infection, also neutropenia and depletion of platelets in the blood through chronic disease (TB etc) elsewhere in the body, or through chemicals in food and medicine. Other causes include food preservatives, X-ray radiation, fluoride in water supply and environmental pollution. The condition is serious.

Possibility of mercurial poisoning. A 59-year-old man employed filling thermometers with mercury developed aplastic anaemia and died. His urine contained 1.01mg mercury per litre. (D.R. Ryrie. Brit. Medical Journal, i/1970, 499. A similar report D.R. Wilson, ibid., ii/1966, 1534)

Symptoms. Headache, dizziness, pallor of skin, loss of weight and appetite, sore or burning tongue, jaundice, bruising, nose-bleeds. A low state of the immune system exposes the subject to infection. Treatment. Hospital supervision. Necessary to identify the causative toxic agent and eliminate it. Condition fails to respond to usual preparations of iron taken by mouth. No specific exists but supportive adaptogen herbs sustain and raise haemoglobin levels, marginally increasing red cells.

To facilitate elimination of toxic chemicals:– Teas: Alfalfa, Red Clover, German Chamomile, Ground Ivy, Milk Thistle, Gotu Kola, Nettles, Fennel.

Tea. Formula. Equal parts: Dandelion, Nettles, Alfalfa. 1 heaped teaspoon in each cup boiling water, infuse 10-15 minutes. One cup freely.

Decoction: Gentian – 1 teaspoon in cup cold water. Steep overnight; drink on rising.

Tinctures. To stimulate bone marrow. Formula: equal parts, Echinacea, Prickly Ash bark, Horsetail. Dose: 1-2 teaspoons thrice daily, taken in water or cup of one of the above teas.

Tincture Cinnamon BP (1949). Dose: 2-4ml (30-60 drops).

Powders. Combine: Gentian 1; Yellow Dock 1; Echinacea 2; Cinnamon quarter; Cayenne quarter. Dose: 500mg (two 00 capsules or one-third teaspoon), before meals.

Liquid Extracts: Combine Echinacea 2; Black Cohosh half; Damiana 1; Ginger quarter. Dose: 1 teaspoon in cup Red Clover tea, before meals.

Diet. Dandelion coffee, high fibre, low fat, low salt, molasses, lamb’s liver. Foods containing Vitamin B12.

Supplements daily. Vitamin B12. Folic acid 400mcg, Vitamin C, Floradix. ... anaemia: aplastic

Anaemia: Iron Deficiency

An estimated 15 per cent of the female population suffers from this form of anaemia. A deficiency of nutritional iron is responsible for oxygen starvation of the blood due to insufficient haemoglobin. Number of red cells is reduced.

Aetiology: heavy menstrual loss, feeble constitution from hereditary weakness, poor diet, hidden or known blood loss from gastric ulcer, pregnancy, bleeding piles or insufficient food minerals: iron, copper, calcium, etc, chronic liver or kidney disease, worms, anorexia nervosa, rheumatoid arthritis, tuberculosis. Symptoms. Tiredness, dizziness, breathlessness, palpitations, pale face and mucous membranes. White of eyes may be blue. Enlarged flabby tongue often bears impression of teeth marks. Hair lifeless, fingernails brittle and ridged. There may be angina, tinnitus and general reduced efficiency.

Treatment. The object is to achieve absorption of iron to raise normal haemoglobin levels and increase red cells. Echinacea has a reputation for regeneration of red cells. Herbs used with success: Echinacea, Gentian, Motherwort, Mugwort, Barberry, Hops, Nettles, Saw Palmetto, Chaparral, Red Clover, Dandelion.

Bitter herbs stimulate absorption of vital nutrients from the stomach, toning liver and pancreas, increasing the appetite; usually given half hour before meals. See: BITTERS.

Gentian. 1 teaspoon fine-cut chips to 2 cups cold water steeped 8 hours (overnight). Dose: Half-1 cup thrice daily before meals.

Tea. Formula. Combine: Agrimony 1; Barberry bark 1; Nettles 2; White Poplar bark half. Place 1oz (30g) in 1 pint (500ml) cold water and bring to boil. Simmer 10 minutes. Drink cold: Half-1 cup thrice daily, before meals.

Powders. Formula. Echinacea 2; Gentian 1; Kelp 1; pinch Red Pepper. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily, before meals.

Liquid extracts. Formula: Echinacea 1; Queen’s Delight 1; Ginseng 1; Ginger quarter. Dose: 30-60 drops in water, thrice daily, before meals.

Infusion Gentian Co Conc BP (1949). Dose: 30-60 drops.

Diet. Dandelion coffee, as desired. Molasses. Desiccated liver.

Floradix. A pre-digested iron preparation. Readily assimilable by the body. Compounded by Dr Otto Greither (Salus Haus). Iron is fed onto yeast which breaks down the metal and absorbs its cells. Other tonic ingredients include extracts of nettles, carrots, spinach, fennel, Vitamin C plus supplements;

Angelica root, Mallow, Horsetail, Yarrow, Juniper and Rosehips. Not chemically preserved.

Avoid chocolate, egg yolk, tea, coffee, wheat bran.

Supplements. Daily. Vitamin C (1g morning and evening). Vitamin B12, Folic acid 400mcg. Vitamin C is the most potent enhancer of iron absorption. Multivitamin containing iron.

Note: Iron absorption is decreased by antacids, tetracyclines, phosphates, phytates (phytic acid from excessive intake of wholewheat bread), and excessive calcium supplements. Lack of stomach hydrochloric acid impairs iron absorption, especially in the elderly. ... anaemia: iron deficiency

Iron-deficiency Anaemia

See anaemia, iron-deficiency.... iron-deficiency anaemia

Megaloblastic Anaemia

See anaemia, megaloblastic.... megaloblastic anaemia

Anaemia: Pernicious

A form of anaemia following a deficiency of Vitamin B12. Usually occurs middle life, 45-60.

Symptoms. Skin of yellow tinge, failing eyesight, swollen ankles, feeble heart action, numbness of feet and legs, dyspepsia, tingling in limbs, diarrhoea, red beefy sore tongue, patches of bleeding under skin, unsteadiness and depression.

Treatment. Hospitalisation. Intramuscular injections of Vitamin B12. Herbs known to contain the vitamin – Comfrey, Iceland Moss. Segments of fresh Comfrey root and Garlic passed through a blender produce a puree – good results reported.

Alternatives:– Teas: Milk Thistle, Hops, Wormwood, Betony, White Horehound, Motherwort, Parsley, Nettles, Centuary.

Formula. Combine Centuary 2; Hyssop 1; White Horehound 1; Red Clover flower 1; Liquorice quarter. 1-2 teaspoons to each cup boiling water, infuse 15 minutes. 1 cup thrice daily.

Decoction. Combine Yellow Dock 1; Peruvian bark quarter; Blue Flag root quarter; Sarsaparilla 1; Bogbean half. 1 teaspoon to each cup of water, or 4oz (30 grams) to 1 pint (half litre) water. Simmer gently 10-15 minutes in covered vessel. Dose: Half-1 cup, thrice daily.

Decoction. Combine Yellow Dock 1; Peruvian bark quarter; Blue Flag root quarter; Sarsaparilla 1; Bogbean half. 1 teaspoon to each cup of water, or 4oz (30 grams) to 1 pint (one-half litre) water. Simmer gently 10-15 minutes in covered vessel. Dose: Half-1 cup, thrice daily.

Tablets/capsules. Echinacea, Dandelion, Kelp.

Powders. Formula. Equal parts: Gentian, Balm of Gilead, Yellow Dock. Dose: 500mg (two 00 capsules or one-third teaspoon), thrice daily before meals.

Liquid Extracts. Combine, Echinacea 2; Gentian 1; Dandelion 1; Ginger quarter. Dose: 15-30 drops in water thrice daily.

Gentian decoction. 1 teaspoon dried root to each cup cold water.

Diet. Dandelion coffee. Calves’ liver. Absorption of nutritious food may be poor through stomach’s inability to produce sufficient acid to break down food into its elements. Indicated: 2-3 teaspoons Cider vinegar in water between meals. Contraindicated – vegetarian diet.

Supplements. Vitamin B12, (in absence of injections). Iron – Floradix. Desiccated liver. Vitamin C 1g thrice daily at meals. Folic acid. 400mcg thrice daily. ... anaemia: pernicious

Anaemia: Sickle Cell

A form of anaemia growing into an acute social problem, affecting people of African, Asian, and Mediterranean origin. Thalassaemias are caused by defects of a gene that produces the globin part of haemoglobin. Such defects in the DNA can now be detected in the womb before birth. The name derives from sickle-shaped cells instead of circular red blood cells. Few sufferers survive beyond their 40th year.

Symptoms. Unhealthy pallor, listlessness, sore tongue, dizziness, vague aches and pains, rapid pulse and breathing, tinnitus, palpitation. The skull may be disproportionately large, resistance to infection feeble, chances of survival poor. This form of anaemia is linked with defective colour vision. Impaired liver function. Stunted growth, great pain. Sufferers have a higher risk of infection.

Malaria. Sufferers are less likely to die of malaria because their red cells do not support the growth of malaria parasites very well.

Carriers: Carriers of the sickle-cell gene can now be identified by a simple blood test.

Treatment. No specifics exist but supportive herbal treatment has been known to increase output of red cells and raise haemoglobin levels:– Red Clover flowers, Yellow Dock, Echinacea, Burdock, Wild Indigo, Gentian, Nettles, Birch leaves, Sage, Walnut leaves, Centaury, Gota Kola (Indian Pennywort). Alternatives:– Tea. Mix equal parts: Iceland Moss, Nettles, Red Clover flowers. 2 teaspoons to each cup boiling water; infuse 15 minutes; 1 cup morning and evening.

Decoction. Mix equal parts; Echinacea, Walnut leaves, Balm of Gilead buds; 1 teaspoon to each cup water gently simmered for 20 minutes. Half-1 cup, cold, 3 times daily, before meals.

Tablets/capsules. Sarsaparilla. Ginseng. Iceland Moss. Red Clover. Echinacea. Gentian.

Powders. Formula: Echinacea 1; Fringe Tree half; Ginseng half; White Poplar bark 1. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily before meals.

Liquid extracts. Formula. Echinacea 2; Dandelion 1; Oat Husk (avena sativa) 1. Mix. Dose, 1-2 teaspoons before meals, in water or one of the above teas or decoctions.

Tinctures. Same combination. Dose: 2-3 teaspoons.

Dong quai. See entry.

Pollen. Claimed to be of value.

Diet. Dandelion coffee. Molasses. Desiccated liver. Calf liver, fresh. Green leafy vegetables contain chlorophyll, iron and folic acid. Cider vinegar. Dried beans, apricots and shellfish. Dandelion leaves in salads. Milk, eggs, meats, Soya. Carrot juice to increase red cells.

Supplements. Daily. Vitamin B12. Vitamin C, 1g; Folic acid 400mcg, Floradix. Of particular value: Vitamin E 400iu. Zinc.

Note: Those at risk should submit themselves for screening. The disease cannot be cured but can be controlled largely by orthodox measures and sometimes by natural medicine. ... anaemia: sickle cell

Haemolytic Disease Of Infants

Severe disease of the newly born and infants with jaundice and anaemia. Occurs when a Rhesus negative mother gives birth to a Rhesus positive child. There may be degeneration of nerve cells of the brain through circulating bile. Followed by water-logging of tissues lining lungs, abdomen or heart (hydrops).

Treatment. Purpose of medication is to stimulate flow of bile and support the liver.

Arthur Hyde, MNIMH recommends a selection from the following according to individual case: Balmony, Barberry, Dandelion, Goldenseal, Hops, Ladyslipper, Mistletoe, Passion flower, Stone root. Tinctures. Formula. Marigold 2; Barberry 2; Ginkgo 1. Dose: 2 drops in feed, or in water, thrice daily. Infants 3-5 years: 10 drops.

To be treated by or in liaison with a qualified medical practitioner. ... haemolytic disease of infants

Haemolytic-uraemia Syndrome (hus)

An uncommon cause of kidney failure in children. The association of three processes: reduced platelets, haemolytic anaemia and kidney failure. Foodborne infection is spread by micro-organisms (E. coli, etc) with an affinity for the alimentary canal. The central nervous system is involved.

Onset: diarrhoea with streaks of blood, vomiting, breathlessness, feverishness, dizziness, jaundice and enlargement of the spleen.

Other causes may be mismatched food transfusion, environmental chemicals, nitrite food preservatives and analgesic drugs.

Alternatives. Tea. Combine herbs: Red Clover (to increase platelets) 3; Yarrow (kidneys) 2; Hops (cerebrospinal supportive) 1. 1-2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup freely.

Formula: Combine, Tinctures. Red Clover 2; Fringe Tree 1; Hops half. Dose: one 5ml teaspoon. Babies: 2 drops in feed; infants 3-5 years 10 drops in water and honey thrice daily.

Supplementation. Vitamin B-complex. C.

To be treated by or in liaison with a qualified medical practitioner. ... haemolytic-uraemia syndrome (hus)

Jaundice, Haemolytic

Caused by disease toxins that kill off red blood cells, or autoimmune disease.

Treatment: emphasis is on new red cell production. Dosage would be according to individual tolerance. Alternatives. Tea. Mix equal parts: Agrimony, Clivers, Red Clover flowers. 2 teaspoons to each cup boiling water; infuse 5-15 minutes; one cup every 3 hours.

Decoction. Equal parts: Fringe Tree, Gentian, Milk Thistle. 2 teaspoons to each cup water gently simmered 20 minutes. Half-1 cup every 3 hours, or as much as tolerated.

Tablets/capsules. Red Clover, Ginseng.

Formula. Equal parts: Fringe Tree, Yellow Dock root, Dandelion. Dose – Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Every 3 hours in water or honey. ... jaundice, haemolytic

Anaemia, Aplastic

A rare but serious type of anaemia in which the red cells, white cells, and platelets in the blood are all reduced in number. Aplastic anaemia is caused by a failure of the bone marrow to produce stem cells, the initial form of all blood cells.

Treatment of cancer with radiotherapy or anticancer drugs can temporarily interfere with the cell-producing ability of bone marrow, as can certain viral infections and other drugs. Long-term exposure to insecticides or benzene fumes may cause more persistent aplastic anaemia, and a moderate to high dose of nuclear radiation is another recognized cause. An autoimmune disorder is responsible in about half of all cases. Aplastic anaemia sometimes develops for no known reason.

A low level of red blood cells may cause symptoms common to all types of anaemia, such as fatigue and breathlessness. White-cell deficiency increases susceptibility to infections; platelet deficiency may lead to a tendency to bruise easily, bleeding gums, and nosebleeds.

The disorder is usually suspected from blood-test results, particularly a blood count, and is confirmed by a bone marrow biopsy.

Blood and platelet transfusions can control symptoms.

Immunosuppression is used to treat anaemia due to an autoimmune process.

Severe persistent aplastic anaemia may be fatal unless a bone marrow transplant is carried out.... anaemia, aplastic

Anaemia, Haemolytic

A form of anaemia caused by premature destruction of red cells in the bloodstream (haemolysis). Haemolytic anaemias can be classified according to whether the cause of haemolysis is inside or outside the red cells.

When haemolysis is due to a defect inside the red cells, the underlying problem is abnormal rigidity of the cell membrane. This causes the cells to become trapped, at an early stage of their life-span, in the small blood vessels of the spleen, where they are destroyed by macrophages (cells that ingest foreign particles). Abnormal rigidity may result from an inherited defect of the cell membrane (as in hereditary spherocytosis), a defect of the haemoglobin in the cell (as in sickle-cell anaemia), or a defect of one of the cell’s enzymes. An inherited deficiency of the glucose-6phosphate dehydrogenase enzyme (see G6PD deficiency) may result in episodes of haemolytic anaemia since the red cells are prone to damage by infectious illness or certain drugs or foods.

Haemolytic anaemias due to defects outside the red cells fall into 3 main groups. First are disorders in which red cells are destroyed by buffeting (by artificial surfaces such as replacement heart valves, abnormal blood-vessel linings, or a blood clot in a vessel, for example). In the 2nd group, the red cells are destroyed by the immune system. Immune haemolytic anaemias may occur if foreign blood cells enter the bloodstream, as occurs in an incompatible blood transfusion, or they may be due to an autoimmune disorder. In haemolytic disease of the newborn, the baby’s red cells are destroyed by the mother’s antibodies crossing the placenta. Thirdly, the red cells may be destroyed by microorganisms; the most common cause is malaria. People with haemolytic anaemia may have symptoms common to all types of anaemia, such as fatigue and breathlessness, or symptoms specifically due to haemolysis, such as jaundice.

Diagnosis is made by examination of the blood (see blood film). Some inherited anaemias can be controlled by removing the spleen (see splenectomy). Others, such as G6PD deficiency, can be prevented by avoiding the drugs or foods that precipitate haemolysis. Anaemias due to immune processes can often be controlled by immunosuppressant drugs. Transfusions of red cells are sometimes needed for emergency treatment of life-threatening anaemia.... anaemia, haemolytic

Anaemia, Iron-deficiency

The most common form of anaemia caused by a deficiency of iron, an essential constituent of haemoglobin. The main cause of iron-deficiency anaemia is iron loss due to heavy or persistent bleeding; the most common cause in women of childbearing age is menstruation. Other causes include blood loss from the digestive tract due to disorders such as erosive gastritis, peptic ulcer, stomach cancer, inflammatory bowel disease, haemorrhoids, and bowel tumours (see colon, cancer of). Prolonged use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause gastrointestinal bleeding. In some countries, hookworm infestation of the digestive tract is an important cause of anaemia. Rarely, bleeding may also occur as a result of disorders of the urinary tract (such as kidney tumours or bladder tumours).

Iron deficiency may also be caused or worsened by lack of iron in, or its poor absorption from, the diet.

The symptoms are those of the underlying cause, along with a sore mouth or tongue, and those common to all forms of anaemia, such as fatigue and breathlessness. The diagnosis is made from blood tests and tests to look for an underlying cause. Treatment is given for the cause, along with a course of iron tablets or, very rarely, injections.... anaemia, iron-deficiency

Anaemia, Megaloblastic

An important type of anaemia caused by a deficiency of vitamin B12 or another vitamin, folic acid. Either of these deficiencies seriously interferes with production of red blood cells in the bone marrow. An excess of cells called megaloblasts appears in the marrow. Megaloblasts give rise to enlarged and deformed red blood cells known as macrocytes.

Vitamin B12 is found only in foods of animal origin, such as meat and dairy products. It is absorbed from the small intestine after first combining with intrinsic factor, a chemical produced by the stomach lining. The most common cause of vitamin B12 deficiency is failure of the stomach lining to produce intrinsic factor, usually due to an autoimmune disorder; this is called pernicious anaemia. Total gastrectomy (removal of the stomach) prevents production of intrinsic factor, and removal of part of the small intestine prevents B12 absorption, as does the intestinal disorder Crohn’s disease. In a minority of cases, vitamin B12 deficiency is due to a vegan diet.

Folic acid is found mainly in green vegetables and liver. The usual cause of deficiency is a poor diet. Deficiency can also be caused by anything that interferes with the absorption of folic acid from the small intestine (for example Crohn’s disease or coeliac disease). Folic acid requirements are greater than normal in pregnancy.

Many people with mild megaloblastic anaemia have no symptoms. Others may experience tiredness, headaches, a sore mouth and tongue, and mild jaundice. If B12 deficiency continues for a long time, additional symptoms due to nerve damage, including numbness and tingling in the feet, may develop.

Megaloblastic anaemia is diagnosed by blood tests and a bone marrow biopsy. Megaloblastic anaemia due to poor diet can be remedied with a short course of vitamin B12 injections or folic acid tablets and the introduction of a normal diet. A lifelong course of vitamin B12 injections or folic acid tablets is required if the underlying cause of malabsorption is untreatable.... anaemia, megaloblastic

Sickle Cell Anaemia

An inherited blood disease in which the red blood cells contain haemoglobin S, an abnormal type of haemoglobin. This crystallizes in the capillaries, making red cells sickle-shaped and fragile, and leading to haemolytic anaemia. The abnormal cells are unable to pass easily through tiny blood vessels. The blood supply to organs is blocked intermittently, causing sickle cell crises. The disease affects mainly black people.Symptoms usually appear after age 6 months, often beginning with painful swelling of the hands and feet. Chronic haemolytic anaemia causes fatigue, headaches, shortness of breath on exertion, pallor, and jaundice. Sickle cell crises start suddenly; they are sometimes brought on by an infection, cold weather, or dehydration, but may also occur for no apparent reason. The sufferer may experience pains (especially in the bones), blood in the urine (from kidney damage) or damage to the lungs or intestines. If the brain is affected, seizures, a stroke, or unconsciousness may result.

In some affected children, the spleen enlarges and traps red cells at a particularly high rate, causing a life-threatening form of anaemia. After adolescence, the spleen usually stops functioning, increasing the risk of infection in those affected.

Diagnosis is made from examination of a blood smear and electrophoresis.

Supportive treatment may include folic acid supplements, and penicillin and immunization to protect against infection.

Life-threatening crises are treated with intravenous infusions of fluids, antibiotics, oxygen therapy, and analgesic drugs.

If the crisis still does not respond, an exchange blood transfusion may be performed.

This may be done regularly for people who suffer frequent severe crises.... sickle cell anaemia

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