What is Anaemia/ Anemia?
Anemia is most common hematological problem.Anemia in simple language means low hemoglobin. Hemoglobin less than 13gm/dl in men and 12 g/dL in women is considered as anemia. Unfortunately, many people think Hemoglobin in range of 7-9gm/dl is normal.
What are the symptoms of Anemia?
Fatigue ,loss of appetite,breathlessness,pica (craving for things you are not supposed to eat),pale hands ,hair fall,headache, difficulty in concentration,weakness ,etc. are few common symptoms of anemia.
What are causes of anaemia?
Most common type of anemia in India are nutritional anaemias and in that iron deficiency anemia is most common. As significant proportion of population in India is vegetarian vitamin B12 deficiency leading on to anemia is another common cause. Apart from this other causes of anemia are folate deficiency, renal and liver diseases, endocrine/ hormonal problems,abnormal hemoglobin disorders like thalassemia and sickle cell anemia. In rare cases anemia can be secondary to underlying cancer which can be blood cancer or solid tumor.
How are Anaemia’s Diagnosed?
First step in diagnosis of anemia is CBC (complete blood count) on a good haematological analyser. Next step should be examination of peripheral smear and re&culocyte count. Depending on the clinical history provided and basic lab investigation various other diagnostic tests can be done like iron profile including ferritin, serum b12, serum folate, hemoglobin electrophoresis (HPLC for abnormal hemoglobin), liver function tests and renal function tests.
Difficult to diagnoses Case?
Sometimes, we do not conclude from above sets of investigations and hence we require additional sets of investigations. This include Direct Coombs test, Osmotic Fragility, G6PD levels, Bone Marrow Aspiration, Bone Marrow Biopsy, Immunohistochemistry, Conventional Karyotype, PET CT Scan or Biopsy of enlarged gland/ lymphnode. Other additional testing might include Serum Protein Electrophoresis etc.
Treatment of Anemia?
Treatment of anemia is according to underlying cause. Example Iron tabs/ Iron Injections in those with iron deficiency. We shall discuss in detail individual anemia treatments in subsequent blogs.