Anaemia

          Anaemia 

It is a clinical condition in which there is qualitative or quantitative decrease in haemoglobin concentration below normal level

According WHO estimation:-

1:-1/3rd of all women of reproductive age group are anaemic.

2:-Among pregnant women 40% are anaemic.

3:-Over 40%of children under 5years of age are anaemic.

Normal hemoglobin concentration (adult):-

Measurement	Men	Women
Hemoglobin(g/dl)	13.6-17.2	12-15

Grading of Anemia:-

     

	Anemia severity	Hb level(g/dl)
1.	Mild	9-10
2.	Moderate	7.0-9
3.	Severe	<7

Clinical findings in Anemia:-

• Pale 
• Weakness
• Malaise
• Easy fatigability
• Faintness
• Dimness of vision

Other findings:-

1. Dyspnea
2. Fatty changes in liver, myocardium and kidneys(due to hypoxia)

Causes of Anemia:-

(1) Blood loss 

(a) acute blood loss  

        -trauma

        - haemorrhage

(b) chronic blood loss 

       -GIT lesions 

       -menstrual disturbances

       - parasite infestation in GIT

(2) Incresed red cell destruction (hemolysis)

(a) inherited genetic defects:-

      -hereditary spherocytosis

      -G6PD deficiency

(b)Hb abnormalities:-

     -thalassemia syndromes

     -sickle cell disease

(c) Acquired genetic defects:

     -paroxysmal nocturnal  hemoglobinurea

(d) Antibody-mediated destruction:-

      -Rh disease

      -transfusion reactions

      - drug induced

(e) Mechanical trauma:-

       -Disseminated intravascular coagulation

      -thrombotic thrombocytopenia purpura 

(f) Infections of red cells 

      - Malaria 

(g) Toxic or chemical injury:

      -clostridial sepsis

       - snake venom

       -lead poisoning

(h) Sequestration:-

      -hypersplenism

(3) Decreased red cell production:-

(a) Inherited genetic defects:-

      -Fanconi Anemia

      -thalassemia syndromes

(b) Nutritional deficiencies :-

      -B12 and folate deficiency

 (c) Erythropoietin deficiency