Anemia. Red blood cells

"Although most often in our environment, anemia is due to a lack of iron (ferropenia), it is essential to correctly identify its cause in order to treat it properly".

DR. RAMÓN LECUMBERRI VILLAMEDIANA
CODIRECTOR. HAEMATOLOGY AND HAEMOTHERAPY DEPARTMENT

Anemia is defined as a decrease in the number of red blood cells (or red blood cells) in the blood or in hemoglobin levels from normal values.

The main function of red blood cells is the transport of oxygen in the blood and its release into various tissues. Oxygen is carried within the hematyre attached to the hemoglobin.

Anemia can be the manifestation of a hematological disease or a secondary manifestation of many other diseases.

Certain types of anemia can be serious, long-lasting, and even life-threatening if not diagnosed and treated.

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What are the symptoms of anemia?

Anemia can be acute or chronic and the symptoms are different depending on how quickly it appears.

Mild anemia begins to manifest itself as decreased resistance to physical exercise, accompanied by tachycardia and shortness of breath. If the anemia becomes more intense, these symptoms are accentuated and they appear with minimum efforts or even in rest, being associated to extreme tiredness.

The patient may be pale, with low coloring of the skin and mucous membranes. A headache may occur and, in patients with cardiovascular disease, angina may be triggered.

However, in anemias that develop over a very long period of time, the body adapts its systems to that anemia and the patient may have very few or almost no symptoms, especially if he or she does not exercise regularly.

What are the most common symptoms?

  • Fatigue
  • Skin paleness
  • Tachycardia
  • Breathing difficulty
  • Fragility of hair and/or nails

When anemia sets in very suddenly, as in acute hemorrhages, the symptoms depend mainly on the loss of blood volume inside the vessels and different degrees of vascular collapse, pallor, sweating, tachycardia and arterial hypotension can develop, and the patient's life can be in danger.

Do you have any of these symptoms?

You may suffer from anemia

What are the causes of anemia?

Red blood cells can be diminished for three main reasons: 

  • Because not enough are produced, as happens in spinal cord aplasias, in bone marrow infiltration by tumors, in anemia produced by iron deficiency, in the anemia that accompanies many chronic diseases such as rheumatic diseases and in the disease associated with chronic renal failure.
  • Because there is a disorder in the maturation of these red blood cells in the bone marrow where they are formed. This happens in anemias associated with vitamin B12 or folate deficiency, as well as in other hematological diseases such as refractory anemias.
  • Because they are destroyed or lost at greater speed. It can be caused by the acute loss of blood that occurs in hemorrhages of any kind, by hemolysis or intravascular rupture of red blood cells of mechanical or autoimmune cause and by alterations of the membrane of hematy or hemoglobin, many of them hereditary.

What are the complications of anemia?

When the degree of anemia is severe, red blood cells and hemoglobin will not be sufficient to carry the necessary oxygen to the rest of the body. If the body's organs do not have enough oxygen, they can become inflated.

In pregnant women, their babies can be born small and underweight.

When anemia is due to major bleeding, blood loss, if not stopped in time, can lead to death.

How is anemia diagnosed?

<p>Imagen de tubos de análisis de sangre del Laboratorio de Hematología de la Clínica Universidad de Navarra&nbsp;</p>

The initial diagnosis is apparently simple, since in a routine analysis or for other reasons a decrease in the levels of hemoglobin or the number of red blood cells is detected.

However, the analyses not only allow the diagnosis of anemia, but through the examination of a series of characteristics of these red blood cells, such as their size or the concentration of hemoglobin they contain, many data can be known that allow the diagnostic process of the type of anemia in question to be initiated.

The complete study, once the anemia has been detected, will require extending the analytical study, examining an extension of peripheral blood and, in some cases, performing an aspiration or a biopsy of the bone marrow.

How is anemia treated?

It is essential to know well the type of anemia to establish the most appropriate treatment

Since anemia can be the result of many and diverse diseases, it is essential to reach a diagnosis before any treatment.

Only in those cases in which a sudden anemia could be life-threatening for the patient will it be necessary an urgent replacement through transfusions of concentrated red blood cells from donations.

In the rest of the cases, which are the majority, treatment should not be established until the cause of the illness is known. Anemias due to iron, vitamin B12 or folic acid deficit are treated by providing these principles. Anemias secondary to chronic inflammatory diseases improve with effective treatment of the causative disease.

In recent years, the use of growth factors such as erythropoietin has made it possible to treat many forms of anemia very effectively.

Where do we treat it?

IN NAVARRE AND MADRID

The Hematology and Hemotherapy Service of the
at the Clínica Universidad de Navarra

The Hematology Service of the Clinic, formed by specialists of recognized national and international prestige, has integrated molecular diagnostic techniques and the use of new personalized treatments in its assistance work, allowing a more precise and fast diagnosis of the hematological diseases.

The joint work of the medical staff and the researcher facilitates the development and application of the new treatments and at the same time the precise evaluation of the result of the treatments.

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