Severe Anaemia
 


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Severe Anaemia

What is Severe Anaemia?

Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia can make you feel tired and weak.
There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe. See your doctor if you suspect that you have anemia. It can be a warning sign of serious illness.
Anemia is a reduced number of red cells or a reduced amount of hemoglobin (Hb) in each red cell. Hemoglobin in the blood carries oxygen from the lungs to the tissues where it releases the oxygen to burn nutrients to provide energy to power the functions of the body, and collects the resultant carbon dioxide to bring it back to the lungs to be dispensed from the body.
Severe anemia may impair growth motor and mental development. Children may exhibit a reduced physical development (decreased work output and capacities), and reduced cognitive development (diminished concentration, disturbance in perception and poor learning abilities).
As per NFHS 3 survey (2005-06), 70% of children are anemic and 3% severely anemic. It is important, to remember, that mostly there is no symptom of anemia unless the Hb is below 8g/dl or 6 g/dl. Sometimes even at still lower levels patient may not be aware of anemia.

Cause

The causes of anemia is also classified as impaired red somatic cell (RBC) production, accrued blood corpuscle destruction (hemolytic anemias), blood loss and fluid overload (hypervolemia). many of those might interaction to cause anemia. the foremost common reason for anemia is blood loss, however this typically doesn't cause any lasting symptoms unless a comparatively impaired blood corpuscle production develops, successively most ordinarily by iron deficiency.

Diagnosis & Tests

Anemia is usually diagnosed on a complete blood count. except reporting the quantity of red blood cells and therefore the Hb level, the automated counters conjointly measure the scale of the red blood cells by flow cytometry, that is a crucial tool in distinguishing between the causes of anemia. Examination of a stained blood smear employing a magnifier may be useful, and it's typically a necessity in regions of the planet where automatic analysis is less accessible.In modern counters, four parameters (RBC count, Hb concentration, MCV and RDW) are measured, permitting others (hematocrit, MCH and MCHC) to be calculated, and compared to values adjusted for age and sex. Some counters estimate hematocrit from direct measurements.Reticulocyte counts, and therefore the "kinetic" approach to anemia, became more common than within the past within the giant medical centers of the us and a few different loaded nations, partly as a result of some automatic counters currently have the capability to incorporate red blood cell counts. A red blood cell count could be a quantitative measure of the bone marrow's production of recent red blood cells. The red blood cell production index is a calculation of the quantitative relation between the extent of anemia and therefore the extent to that the red blood cell count has up in response. If the degree of anemia is critical, even a "normal" red blood cell count really could replicate an inadequate response. If an automatic count isn't offered, a red blood cell count may be done manually following special staining of the blood film. In manual examination, activity of the bone marrow may be gauged qualitatively by delicate changes within the numbers and therefore the morphology of young RBCs by examination beneath a magnifier. new shaped RBCs are typically slightly larger than older RBCs and show polychromasia. Even wherever the supply of blood loss is clear, analysis of organic process will facilitate assess whether or not the bone marrow are going to be able to complete the loss, and at what rate. once the cause isn't obvious, clinicians use different tests, such as: ESR, ferritin, serum iron, transferrin, red blood cell B level, humour antipernicious anemia factor, Hb activity, excretory organ perform tests (e.g. serum creatinine) though the tests can depend upon the clinical hypothesis that's being investigated. once the identification remains tough, a bone marrow examination permits direct examination of the precursors to red cells, though isn't used as is painful, invasive and is thence reserved for cases wherever severe pathology has to be determined or excluded.

Prevention & Risk Factors

Certain groups of individuals, such as pregnant women, benefit from the use of iron pills for prevention. Dietary supplementation, without determining the specific cause, is not recommended.The use of blood transfusions is typically based on a person's signs and symptoms.In those without symptoms, they are not recommended unless hemoglobin levels are less than 60 to 80 g/L (6 to 8 g/dL).

Treatments & Therapies

Treatment for anemia depends on cause and severity. Vitamin supplements given orally (folic acid or vitamin B12) or intramuscularly (vitamin B12) will replace specific deficiencies.

Oral iron
Nutritional iron deficiency is common in developing nations. An estimated two-thirds of children and of women of childbearing age in most developing nations are estimated to have iron deficiency without anemia; one-third of them have iron deficiency with anemia. Iron deficiency due to inadequate dietary iron intake is rare in men and postmenopausal women. The diagnosis of iron deficiency mandates a search for potential sources of blood loss, such as gastrointestinal bleeding from ulcers or colon cancer.Mild to moderate iron-deficiency anemia is treated by oral iron supplementation with ferrous sulfate, ferrous fumarate, or ferrous gluconate. When taking iron supplements, stomach upset or darkening of the feces are commonly experienced. The stomach upset can be alleviated by taking the iron with food; however, this decreases the amount of iron absorbed. Vitamin C aids in the body's ability to absorb iron, so taking oral iron supplements with orange juice is of benefit.In the anemia of chronic kidney disease, recombinant erythropoietin or epoetin alfa is recommended to stimulate RBC production, and if iron deficiency and inflammation are also present, concurrent parenteral iron is also recommended.

Injectable iron
In cases where oral iron has either proven ineffective, would be too slow (for example, pre-operatively) or where absorption is impeded (for example in cases of inflammation), parenteral iron can be used. The body can absorb up to 6 mg iron daily from the gastrointestinal tract. In many cases the patient has a deficit of over 1,000 mg of iron which would require several months to replace. This can be given concurrently with erythropoietin to ensure sufficient iron for increased rates of erythropoiesis.