Sickle cell anaemia Health Dictionary

Sickle Cell Anaemia: From 1 Different Sources


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.

Health Source: BMA Medical Dictionary
Author: The British Medical Association

Anaemia

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

Basal Cell Carcinoma

A generally slow growing malignant epithelial tumour, which has potential to invade and metastasise, especially if untreated.... basal cell carcinoma

Cell

The smallest unit of living material that can function independently.... cell

Germ Cell

Those embryonic cells with the potential to develop into ova (see OVUM) or spermatozoa (see SPERMATOZOON).... germ cell

Renal Cell Carcinoma

See HYPERNEPHROMA.... renal cell carcinoma

Squamous Cell Carcinoma

Malignant tumour of squamous epithelium of skin, which generally spreads and metastasises.... squamous cell carcinoma

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

Stem Cell

Stem CELLS develop a few days after an egg (ovum) is fertilised by a spermatozoon and starts developing to form an EMBRYO. These master cells are crucial to the development of a normal embryo. They contain a specialised ENZYME that gives them the facility to divide inde?nitely, developing into the many di?erent specialised cells that comprise the various tissues in the body – for example, skin, blood, muscle, glands or nerves.

In a highly signi?cant advance in research, a scienti?c team in the United States obtained stem cells from newly formed human embryos

– donated by women who had become pregnant after successful in vitro fertilisation – and successfully cultivated these cells in the laboratory. This achievement opened the way to replicating in the laboratory, the various specialised cells that develop naturally in the body. UK government legislation constrains the use of human embryos in research (see ETHICS) and the ethical aspects of taking this stem-cell culture technique forwards will have to be resolved. Nevertheless, this discovery points the biological way to the use of genetic engineering in selecting di?erentiated specialised cells from which replacement tissues could be grown for use as transplants to rectify absent or damaged tissues in the human body.

Research into potential use of stem cells has raised expectations that in the long term they may prove to be an e?ective regenerative treatment for a wide range of disorders including PARKINSONISM, ALZHEIMER’S DISEASE, type-2 diabetes (see under DIABETES MELLITUS), myocardial infarction (see HEART, DISEASES OF), severe burns, osteoporosis (see under BONE, DISORDERS OF) and the regeneration of blood to replace the need for BONE MARROW TRANSPLANT. Recent research has shown that adult stem cells may also be stimulated to produce new cell lines. If successful, this would eliminate the need to use embryos and thus resolve existing ethical dilemmas over the use of stem cells.... stem cell

Giant Cell Arteritis

See: ARTERITIS. ... giant cell arteritis

Goblet Cell

A columnar secretory cell occurring in the EPITHELIUM of the respiratory and intestinal tracts.

The cells produce the main constituents of MUCUS.... goblet cell

Haemopoietic Stem Cell

This is the basic cell from which all types of blood cells originate. Its appearance is believed to be similar to that of a LYMPHOCYTE.... haemopoietic stem cell

Nerve Cell

See NEURON(E).... nerve cell

Oat Cell

A type of cell found in one highly malignant form of lung cancer. The cell is small and either oval or round. The nucleus stains darkly and the cytoplasm is sparse and di?cult to identify. Oat-cell, or small-cell, carcinoma of the bronchus is usually caused by smoking, and comprises around 30 per cent of all bronchial cancers. It responds to radiotherapy and chemotherapy but, because the growth has usually spread widely by the time it is diagnosed, the prognosis is poor. Results of surgery are unsatisfactory.... oat cell

Packed Cell Volume

That fraction of the blood’s total volume made up of red cells. The packed cell volume is found by centrifuging blood in a tube and measuring the depth of the column of red cells as a fraction of the whole column of blood. (See also HAEMATOCRIT.)... packed cell volume

Red Blood Cell

See ERYTHROCYTES; BLOOD.... red blood cell

Small-cell Carcinoma

See OAT CELL.... small-cell carcinoma

T-cell

A specialised white cell (lymphocyte) responsible for cell-mediated immunity. See also T-lymphocyte.... t-cell

Target Cell

Abnormal ERYTHROCYTES which are large and ‘?oppy’ and have a ringed appearance, similar to that of a target, when stained and viewed under the microscope. This change from normal may occur with iron-de?ciency ANAEMIA, liver disease, a small SPLEEN, haemoglobinopathies (disorders of HAEMOGLOBIN), and THALASSAEMIA.

A target cell is also a cell that is the focus of attack by macrophages (killer cells – see MACROPHAGE) or ANTIBODIES; it may also be the site of action of a speci?c hormone (see HORMONES).... target cell

White Blood Cell

See LEUCOCYTES.... white blood cell

Aplastic Anaemia

See anaemia, aplastic.... aplastic anaemia

B-cell

See lymphocyte.... b-cell

Cell Division

The processes by which cells multiply. Mitosis is the most common form of cell division, giving rise todaughter cells identical to the parent cells.

Meiosis produces egg (see ovum) and sperm cells that differ from their parent cells in that they have only half the normal number of chromosomes.... cell division

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

Germ Cell Tumour

A growth comprised of immature sperm cells in the male testis or of immature ova in the female ovary. A seminoma is one type of germ cell tumour (see testis, cancer of).... germ cell tumour

Mast Cell

A type of cell that plays an important part in allergy.

In an allergic response, mast cells release histamine.... mast cell

B-lymphocyte (or B-cell)

A type of white blood cell that circulates through the body and is able to detect the presence of the foreign agents. Once exposed to an antigen on the agent, these cells differentiate into plasma cells to produce antibody.... b-lymphocyte (or b-cell)

Cell Salvage Transfusion

See TRANSFUSION.... cell salvage transfusion

Cell-mediated Immunity

A defence mechanism involving the coordinated activity of two subpopulations of TLymphocytes, helper T-Cells and killer T-Cells. Helper T-Cells produce a variety of substances that stimulate and regulate other participants in the immune response. Killer T-Lymphocytes destroy cells in the body that bear foreign antigens (e.g. cells that are infected with viruses or other microorganisms).... cell-mediated immunity

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

Perioperative Cell Salvage

A method of autologous blood TRANSFUSION – using a patient’s own blood, salvaged during a surgical operation – instead of conventional blood-bank transfusion.... perioperative cell salvage

Peripheral-blood Stem-cell Transplants

These have almost completely replaced BONE MARROW TRANSPLANT, used to treat malignancies such as LEUKAEMIA and LYMPHOMA for the past 20 years. The high doses of CHEMOTHERAPY or RADIOTHERAPY used to treat these diseases destroy the bone marrow which contains stem cells from which all the blood cells derive. In 1989 stem cells were found in the blood during recovery from chemotherapy. By giving growth factors (cytokines), the number of stem cells in the blood increased for about three to four days. In a peripheral-blood stem-cell transplant, these cells can be separated from the peripheral blood, without a general anaesthetic. The cells taken by either method are then frozen and returned intravenously after the chemotherapy or radiotherapy is completed. Once transplanted, the stem cells usually take less than three weeks to repopulate the blood, compared to a month or more for a bone marrow transplant. This means that there is less risk of infection or bleeding during the recovery from the transplant. The whole procedure has a mortality risk of less than 5 per cent – half the risk of a bone marrow transplant.... peripheral-blood stem-cell transplants

Schwann Cell

The cells that produce the MYELIN sheath of the AXON of a medullated NERVE. They are wrapped around a segment of the axon, forming concentric layers.... schwann cell

T-cell Lymphoma

See LYMPHOMA.... t-cell lymphoma

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: 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

Apud Cell Tumour

A growth composed of cells that produce various hormones. These cells, amine precursor uptake and decarboxylation (APUD) cells, occur in different parts of the body. Some tumours of the thyroid gland, pancreas, and lungs are cell tumours, as are a carcinoid tumour (see carcinoid syndrome) and phaeochromocytoma (a type of adrenal tumour).... apud cell tumour

Anaemia: Haemolytic

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. ... anaemia: haemolytic

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

Haemolytic Anaemia

See anaemia, haemolytic.... haemolytic anaemia

Iron-deficiency Anaemia

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

Megaloblastic Anaemia

See anaemia, megaloblastic.... megaloblastic anaemia

Antigen-presenting Cell

(APC) a cell, such as a *dendritic cell or a *macrophage, that processes antigen for presentation to a T lymphocytes (see helper T cell).... antigen-presenting cell

Blood Cell

(blood corpuscle) any of the cells that are present in the blood in health or disease. The cells may be subclassified into three major categories, namely red cells (*erythrocytes); white cells (*leucocytes), which include granulocytes, lymphocytes, and monocytes; and *platelets (see illustration). The blood cells account for approximately 40% of the total volume of the blood in health; red cells comprise the vast majority.... blood cell

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

Burr Cell

(echinocyte) a red blood cell (erythrocyte) with abnormal small thorny projections. See crenation.... burr cell

Cell Body

(perikaryon) the enlarged portion of a *neuron (nerve cell), containing the nucleus. It is concerned more with the nutrition of the cell than with propagation of nerve impulses.... cell body

Cell Saver

a machine that aspirates blood lost during surgery and immediately spins, washes, and filters it for retransfusion back into the patient’s body (see autotransfusion). The process, called intraoperative cell salvage, is used in surgery that has significant blood loss, such as orthopaedic and vascular surgery and Caesarean section, and avoids the costs and risks of *allogeneic transfusion.... cell saver

Cell-surface Molecules

molecules on the surface of cell membranes that are responsible for most cellular functions directly related to their immediate environment. Many have very precise functions of adhesion (see adhesion molecules), metabolic exchange, hormone reception, respiration, and immune reactions. Cell-to-cell exchanges involve specialized surface structures (junctions), which form a communicating nexus.... cell-surface molecules

Clear-cell Carcinoma

(clear-cell adenocarcinoma) a variant of *adenocarcinoma that tends to arise from the kidneys or the female genital tract. In the latter case it is linked to intrauterine exposure to *diethylstilbestrol during the 1950s and 1960s and takes the form of a vaginal cancer, which can be treated by radical surgery followed by radiotherapy.... clear-cell carcinoma

Cancer – Squamous Cell Carcinoma

Given three months to live, Jason Winters, terminal cancer patient, was suffering from infiltrating squamous cell carcinoma wrapped round his carotid artery. Refusing major surgery, he travelled the world in search of native remedies. He was able to contact people who put him on the track of Wild Violet leaves, Red Clover flowers (Trifolium pratense) and leaves of the Chaparral bush (Larrea divaricata). The story of how he infused them, together with a well- known spice, is dramatically recorded in his book “Killing Cancer”. After a spectacular recovery, remission has lasted for over 15 years and others have benefited from his experience.

Treatment by oncologist. ... cancer – squamous cell carcinoma

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

Cutaneous T-cell Lymphoma

a group of lymphomas in which abnormal T *lymphocytes are concentrated in the skin. The most common form is *mycosis fungoides.... cutaneous t-cell lymphoma

Cytotoxic T Cell

a type of T *lymphocyte that destroys cancerous cells, virus-infected cells, and *allografts. Cytotoxic T cells recognize peptide antigens attached to proteins that are encoded by the *HLA system.... cytotoxic t cell

Dendritic Cell

a type of haemopoietic cell with specialized antigen-presenting functions. The head and neck are common sites for dendritic cell pathology. See antigen-presenting cell.... dendritic cell

Egg Cell

see ovum.... egg cell

G-cell

n. any of the gastrin-secreting cells of the stomach lining located predominantly in the gastric *antrum. Gastrin stimulates the production of gastric acid by parietal cells in the stomach. Increased G-cell activity is associated with the formation of duodenal ulcers and the *Zollinger-Ellison syndrome.... g-cell

Giant Cell

any large cell, such as a *megakaryocyte. Giant cells may have one or many nuclei.... giant cell

Hairy Cell

an abnormal white blood cell that has the appearance of an immature lymphocyte with fine hairlike cytoplasmic projections around the perimeter of the cell. It is found in a rare form of leukaemia (hairy-cell leukaemia) most commonly occurring in young men.... hairy cell

Helper T Cell

a type of T *lymphocyte that plays a key role in cell-mediated immunity by recognizing foreign antigen on the surface of *antigen-presenting cells when this is associated with the individual’s *MHC antigens, having been processed by antigen-presenting cells. Helper T cells stimulate the production of *cytotoxic T cells, which destroy the target cells.... helper t cell

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

Hilar Cell Tumour

an androgen-producing tumour of the ovary found in older women and often resulting in *virilization. Such tumours are so called as they tend to occur around the area of the ovary where the blood vessels enter (the hilum). They are usually small and are treated by surgical removal, with resolution of most of the symptoms.... hilar cell tumour

Hürthle Cell Tumour

a malignant tumour of the thyroid gland that arises from Hürthle (or Askanazy) cells, altered follicular cells of the gland that have large nuclei and stain deeply with eosin (these cells are also found in benign nodules and Hashimoto’s disease). Hürthle cell carcinoma is not as common as papillary, follicular, or anaplastic thyroid carcinomas (see thyroid cancer). [K. W. Hürthle (1860–1945), German histologist]... hürthle cell tumour

Interstitial-cell-stimulating Hormone

see luteinizing hormone.... interstitial-cell-stimulating hormone

Islet Cell Antibodies

a group of autoantibodies directed against components of the insulin-secreting beta cells of the pancreas. They are usually detectable in the blood of people presenting with type 1 diabetes. Antibodies against *glutamic acid decarboxylase (GAD) in the beta cells have become a more specific test for islet cell antibodies, to help confirm a diagnosis of type 1 diabetes.... islet cell antibodies

Islet Cell Transplantation

a new technique still under evaluation for curing type 1 *diabetes mellitus, which involves the injection of donated cells from the pancreatic *islets of Langerhans into the liver, where it is hoped they will seed and survive. The transplanted cells then take over insulin production from the recipient’s diseased pancreas.... islet cell transplantation

Islet Cell Tumour

any tumour arising in a cell of the pancreatic *islets of Langerhans. These tumours, which include *insulinomas, *glucagonomas, and *somatostatinomas, form one of the two major subclasses of gastrointestinal neuroendocrine tumours, the other being the *carcinoid tumours.... islet cell tumour

Langerhans Cell Histiocytosis

overgrowth of cells of the *reticuloendothelial system. This includes disorders previously called histiocytosis X, including eosinophilic granuloma, Hand–Schüller–Christian disease, and Letterer–Siwe disease. [P. Langerhans (1847–88), German physician and anatomist]... langerhans cell histiocytosis

Memory Cell

a long-lived lymphocyte that is formed following primary infection. It enables a faster and more robust immune response following a second exposure to the antigen.... memory cell

Natural Killer Cell

(NK cell) a type of *lymphocyte that is able to kill virus-infected cells and cancerous cells and mediates rejection of bone-marrow grafts. NK cells are a part of natural (or innate) *immunity. Their function is regulated by a balance between activating receptors, which recognize proteins on cancerous or virus-infected cells, and inhibitory receptors specific for certain molecules encoded by the *HLA system.... natural killer cell

Nk Cell

see natural killer cell.

nm symbol for *nanometre.... nk cell

Non-small-cell Lung Cancer

(NSCLC) any type of lung cancer other than *small-cell lung cancer. Such cancers include *adenocarcinoma of the lung, large-cell carcinomas, and squamous-cell carcinoma of the lung.... non-small-cell lung cancer

Onodi Cell

a posterior ethmoidal sinus air cell (see paranasal sinuses). They are surgically important because of their proximity to the optic nerve and internal carotid artery. [A. Onodi (1857–1919), Hungarian rhinolaryngologist]... onodi cell

Pyramidal Cell

a type of neuron found in the *cerebral cortex, with a pyramid-shaped cell body, a branched dendrite extending from the apex towards the brain surface, several dendrites extending horizontally from the base, and an axon running in the white matter of the hemisphere.... pyramidal cell

Reed–sternberg Cell

a large binucleate cell that is characteristic of *Hodgkin’s disease. [D. Reed Mendenhall (1874–1964), US pathologist; C. Sternberg (1872–1935), Austrian pathologist]... reed–sternberg cell

Regulatory T Cell

(Treg cell) a type of T *lymphocyte that suppresses immune responses.... regulatory t cell

Resting Cell

a cell that is not undergoing division. See interphase.... resting cell

Sickle-cell Disease

(drepanocytosis) a hereditary blood disease that mainly affects people of African ancestry but also occurs in the Mediterranean region and reaches high frequencies in parts of Saudi Arabia and India. It occurs when the sickle-cell gene has been inherited from both parents and is characterized by the production of an abnormal type of *haemoglobin – sickle-cell haemoglobin (Hbs) – which precipitates in the red cells when the blood is deprived of oxygen, forming crystals that distort the cells into the characteristic sickle shape: this process is known as sickling. An excess of sickle cells in the circulation results in blockage of small blood vessels, producing episodes of severe pain (a sickle-cell crisis). Sickle cells are rapidly removed from the circulation, leading to anaemia and jaundice. There is no satisfactory treatment; the highest mortality is in childhood but some patients may live to an age of 60–70 years.

The carrier condition (sickle-cell trait) occurs when the defective gene is inherited from only one parent. It generally causes no symptoms but confers some protection from malaria, which accounts for the high frequency of the gene in malarious areas. If a general anaesthetic is to be given to a patient with this condition, the anaesthetist should be alerted.... sickle-cell disease

Sickle-cell Nephropathy

progressive renal disease developing in 5–8% of patients with *sickle-cell disease. Infarcts in the cortex can occur with sickle-cell crises and present with pain and haematuria. Acute or more insidious damage to the medulla will lead to a urinary concentrating defect and later to papillary necrosis and/or fibrosis. Occlusion of vessels within the glomerular capillary tuft leads to a secondary form of *focal segmental glomerulosclerosis and can present with the *nephrotic syndrome.... sickle-cell nephropathy

Small-cell Lung Cancer

(SCLC) a type of bronchial carcinoma characterized by small cells (or oat cells), small round or oval cells with darkly staining nuclei and scanty indistinct cytoplasm. Small-cell carcinoma is usually related to smoking and accounts for about one-quarter of bronchial carcinomas; it carries a poor prognosis due to early distant spread, typically to bones, liver, and brain. Treatment is primarily with chemotherapy and radiotherapy and paraneoplastic symptoms (see paraneoplastic syndrome) from *ectopic hormone production are common. Compare non-small-cell lung cancer.... small-cell lung cancer

Sternberg–reed Cell

see Reed–Sternberg cell.... sternberg–reed cell

Suppressor T Cell

a type of T *lymphocyte that prevents an immune response by B cells or other T cells to an antigen.... suppressor t cell

Transitional Cell Carcinoma

a form of cancer that affects the urothelium, which lines the urinary collecting system of the kidney, ureters, bladder, and the proximal part of the urethra. It is the most common type of bladder cancer.... transitional cell carcinoma

Treg Cell

see regulatory T cell.... treg cell



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