Anemia Wikip

8/3/2019 Anemia Wikip

1/12

Anemia 1

Anemia

Anemia

Classification and external resources

The pale hand of a woman with severe anemia (right) in comparison to the normal hand of a man (left).

ICD-10D50.

[1]-D64.

[2]

ICD-9 280[3]

-285[4]

DiseasesDB663

[5]

MedlinePlus000560

[6]

eMedicine med/132[7]

emerg/808[8]

emerg/734[9]

MeSH D000740[10]

Anemia ( /nimi/; also spelled anaemia and anmia; from Greek anaimia, meaning lack of blood) is

a decrease in number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood.[11]

[12]

However, it can include decreased oxygen-binding ability of each hemoglobin molecule due to deformity or lack in

numerical development as in some other types of hemoglobin deficiency.

Because hemoglobin (found inside RBCs) normally carries oxygen from the lungs to the tissues, anemia leads to

hypoxia (lack of oxygen) in organs. Because all human cells depend on oxygen for survival, varying degrees of

anemia can have a wide range of clinical consequences.

Anemia is the most common disorder of the blood. There are several kinds of anemia, produced by a variety of

underlying causes. Anemia can be classified in a variety of ways, based on the morphology of RBCs, underlying

etiologic mechanisms, and discernible clinical spectra, to mention a few. The three main classes of anemia include

excessive blood loss (acutely such as a hemorrhage or chronically through low-volume loss), excessive blood cell

destruction (hemolysis) or deficient red blood cell production (ineffective hematopoiesis).

There are two major approaches: the "kinetic" approach which involves evaluating production, destruction and

loss,[13]

and the "morphologic" approach which groups anemia by red blood cell size. The morphologic approach

uses a quickly available and low cost lab test as its starting point (the MCV). On the other hand, focusing early on

the question of production may allow the clinician to expose cases more rapidly where multiple causes of anemia

coexist.
http://en.wikipedia.org/w/index.php?title=Mean_corpuscular_volumehttp://en.wikipedia.org/w/index.php?title=Hematopoiesishttp://en.wikipedia.org/w/index.php?title=Hemolysishttp://en.wikipedia.org/w/index.php?title=Hemorrhagehttp://en.wikipedia.org/w/index.php?title=Oxygenhttp://en.wikipedia.org/w/index.php?title=Hypoxia_%28medical%29http://en.wikipedia.org/w/index.php?title=Tissue_%28biology%29http://en.wikipedia.org/w/index.php?title=Oxygenhttp://en.wikipedia.org/w/index.php?title=Hemoglobin_deficiencyhttp://en.wikipedia.org/w/index.php?title=Hemoglobinhttp://en.wikipedia.org/w/index.php?title=Red_blood_cellhttp://en.wikipedia.org/w/index.php?title=Greek_languagehttp://en.wikipedia.org/w/index.php?title=American_and_British_English_spelling_differences%23Simplification_of_ae_and_oehttp://en.wikipedia.org/w/index.php?title=Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/w/index.php?title=Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/w/index.php?title=File:Loudspeaker.svghttp://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?field=uid&term=D000740http://en.wikipedia.org/w/index.php?title=Medical_Subject_Headingshttp://www.emedicine.com/emerg/topic734.htm#http://www.emedicine.com/emerg/topic808.htm#http://www.emedicine.com/med/topic132.htmhttp://en.wikipedia.org/w/index.php?title=EMedicinehttp://www.nlm.nih.gov/medlineplus/ency/article/000560.htmhttp://en.wikipedia.org/w/index.php?title=MedlinePlushttp://www.diseasesdatabase.com/ddb663.htmhttp://en.wikipedia.org/w/index.php?title=Diseases_Databasehttp://www.icd9data.com/getICD9Code.ashx?icd9=285http://www.icd9data.com/getICD9Code.ashx?icd9=280http://en.wikipedia.org/w/index.php?title=List_of_ICD-9_codeshttp://en.wikipedia.org/w/index.php?title=International_Statistical_Classification_of_Diseases_and_Related_Health_Problemshttp://apps.who.int/classifications/apps/icd/icd10online/?gd60.htm+d64http://en.wikipedia.org/w/index.php?title=ICD-10_Chapter_Dhttp://apps.who.int/classifications/apps/icd/icd10online/?gd50.htm+d50http://en.wikipedia.org/w/index.php?title=ICD-10_Chapter_Dhttp://en.wikipedia.org/w/index.php?title=ICD-10http://en.wikipedia.org/w/index.php?title=International_Statistical_Classification_of_Diseases_and_Related_Health_Problemshttp://en.wikipedia.org/w/index.php?title=File%3AAnemia.JPG


2/12

Anemia 2

Signs and symptoms

Main symptoms that may appear in anemia.[14]

Anemia goes undetermined in many people, and symptoms can be

minor or vague. The signs and symptoms can be related to the anemia

itself, or the underlying cause.

Most commonly, people with anemia report non-specific symptoms of

a feeling of weakness, or fatigue, general malaise and sometimes poor

concentration. They may also report dyspnea (shortness of breath) on

exertion. In very severe anemia, the body may compensate for the lack

of oxygen-carrying capability of the blood by increasing cardiac

output. The patient may have symptoms related to this, such as

palpitations, angina (if preexisting heart disease is present),

intermittent claudication of the legs, and symptoms of heart failure.

On examination, the signs exhibited may include pallor (pale skin,

mucosal linings and nail beds) but this is not a reliable sign. There may be signs of specific causes of anemia, e.g.,

koilonychia (in iron deficiency), jaundice (when anemia results from abnormal break down of red blood cells inhemolytic anemia), bone deformities (found in thalassemia major) or leg ulcers (seen in sickle-cell disease).

In severe anemia, there may be signs of a hyperdynamic circulation: tachycardia (a fast heart rate), bounding pulse,

flow murmurs, and cardiac ventricular hypertrophy (enlargement). There may be signs of heart failure.

Pica, the consumption of non-food based items such as dirt, paper, wax, grass, ice, and hair, may be a symptom of

iron deficiency, although it occurs often in those who have normal levels of hemoglobin.

Chronic anemia may result in behavioral disturbances in children as a direct result of impaired neurological

development in infants, and reduced scholastic performance in children of school age.

Restless legs syndrome is more common in those with iron-deficiency anemia.

Less common symptoms may include swelling of the legs or arms, chronic heartburn, vague bruises, vomiting,

increased sweating, and blood in stool.

Diagnosis

Peripheral blood smear microscopy of a patient

with iron-deficiency anemia.

Anemia is typically diagnosed on a complete blood count. Apart from

reporting the number of red blood cells and the hemoglobin level, the

automatic counters also measure the size of the red blood cells by flow

cytometry, which is an important tool in distinguishing between the

causes of anemia. Examination of a stained blood smear using a

microscope can also be helpful, and is sometimes a necessity in regionsof the world where automated analysis is less accessible.

In modern counters, four parameters (RBC count, hemoglobin

concentration, MCV and RDW) are measured, allowing others

(hematocrit, MCH and MCHC) to be calculated, and compared to

values adjusted for age and sex. Some counters estimate hematocrit

from direct measurements.
http://en.wikipedia.org/w/index.php?title=Mean_corpuscular_hemoglobin_concentrationhttp://en.wikipedia.org/w/index.php?title=Mean_corpuscular_hemoglobinhttp://en.wikipedia.org/w/index.php?title=Hematocrithttp://en.wikipedia.org/w/index.php?title=Red_blood_cell_distribution_widthhttp://en.wikipedia.org/w/index.php?title=Mean_corpuscular_volumehttp://en.wikipedia.org/w/index.php?title=Microscopehttp://en.wikipedia.org/w/index.php?title=Blood_smearhttp://en.wikipedia.org/w/index.php?title=Flow_cytometryhttp://en.wikipedia.org/w/index.php?title=Flow_cytometryhttp://en.wikipedia.org/w/index.php?title=Automated_analyserhttp://en.wikipedia.org/w/index.php?title=Hemoglobinhttp://en.wikipedia.org/w/index.php?title=Red_blood_cellhttp://en.wikipedia.org/w/index.php?title=Complete_blood_counthttp://en.wikipedia.org/w/index.php?title=File%3AIron_deficiency_anemia.jpghttp://en.wikipedia.org/w/index.php?title=Iron-deficiency_anemiahttp://en.wikipedia.org/w/index.php?title=Iron-deficiency_anemiahttp://en.wikipedia.org/w/index.php?title=Restless_legs_syndromehttp://en.wikipedia.org/w/index.php?title=Hemoglobinhttp://en.wikipedia.org/w/index.php?title=Pica_%28disorder%29http://en.wikipedia.org/w/index.php?title=Heart_failurehttp://en.wikipedia.org/w/index.php?title=Ventricular_hypertrophyhttp://en.wikipedia.org/w/index.php?title=Bounding_pulsehttp://en.wikipedia.org/w/index.php?title=Tachycardiahttp://en.wikipedia.org/w/index.php?title=Sickle-cell_diseasehttp://en.wikipedia.org/w/index.php?title=Jaundicehttp://en.wikipedia.org/w/index.php?title=Koilonychiahttp://en.wikipedia.org/w/index.php?title=Nail_bedshttp://en.wikipedia.org/w/index.php?title=Pallorhttp://en.wikipedia.org/w/index.php?title=Heart_failurehttp://en.wikipedia.org/w/index.php?title=Claudicationhttp://en.wikipedia.org/w/index.php?title=Palpitationhttp://en.wikipedia.org/w/index.php?title=Cardiac_outputhttp://en.wikipedia.org/w/index.php?title=Cardiac_outputhttp://en.wikipedia.org/w/index.php?title=Dyspneahttp://en.wikipedia.org/w/index.php?title=Malaisehttp://en.wikipedia.org/w/index.php?title=File%3ASymptoms_of_anemia.svg


3/12

Anemia 3

Age or gender group Hb threshold (g/dl) Hb threshold (mmol/l)

Children (0.55.0 yrs) 11.0 6.8

Children (512 yrs) 11.5 7.1

Teens (1215 yrs) 12.0 7.4

Women, non-pregnant (>15yrs) 12.0 7.4

Women, pregnant 11.0 6.8

Men (>15yrs) 13.0 8.1

|+ WHO's Hemoglobin thresholds used to define anemia[15]

(1 g/dL = 0.6206 mmol/L)

Reticulocyte counts, and the "kinetic" approach to anemia, have become more common than in the past in the large

medical centers of the United States and some other wealthy nations, in part because some automatic counters now

have the capacity to include reticulocyte counts. A reticulocyte count is a quantitative measure of the bone marrow's

production of new red blood cells. The reticulocyte production index is a calculation of the ratio between the level of

anemia and the extent to which the reticulocyte count has risen in response. If the degree of anemia is significant,

even a "normal" reticulocyte count actually may reflect an inadequate response.

If an automated count is not available, a reticulocyte count can be done manually following special staining of the

blood film. In manual examination, activity of the bone marrow can also be gauged qualitatively by subtle changes

in the numbers and the morphology of young RBCs by examination under a microscope. Newly formed RBCs are

usually slightly larger than older RBCs and show polychromasia. Even where the source of blood loss is obvious,

evaluation of erythropoiesis can help assess whether the bone marrow will be able to compensate for the loss, and at

what rate.

When the cause is not obvious, clinicians use other tests: ESR, ferritin, serum iron, transferrin, RBC folate level,

serum vitamin B12

, hemoglobin electrophoresis, renal function tests (e.g. serum creatinine).

When the diagnosis remains difficult, a bone marrow examination allows direct examination of the precursors to redcells.

Classification

Production vs. destruction or loss

The "kinetic" approach to anemia yields what many argue is the most clinically relevant classification of anemia.

This classification depends on evaluation of several hematological parameters, particularly the blood reticulocyte

(precursor of mature RBCs) count. This then yields the classification of defects by decreased RBC production versus

increased RBC destruction and/or loss. Clinical signs of loss or destruction include abnormal peripheral blood smear

with signs of hemolysis; elevated LDH suggesting cell destruction; or clinical signs of bleeding, such as

guiaic-positive stool, radiographic findings, or frank bleeding.

The following is a simplified schematic of this approach:
http://en.wikipedia.org/w/index.php?title=Lactate_dehydrogenasehttp://en.wikipedia.org/w/index.php?title=Peripheral_blood_smearhttp://en.wikipedia.org/w/index.php?title=Reticulocytehttp://en.wikipedia.org/w/index.php?title=Bone_marrow_examinationhttp://en.wikipedia.org/w/index.php?title=Serum_creatininehttp://en.wikipedia.org/w/index.php?title=Renal_functionhttp://en.wikipedia.org/w/index.php?title=Hemoglobin_electrophoresishttp://en.wikipedia.org/w/index.php?title=Vitamin_B12http://en.wikipedia.org/w/index.php?title=Folatehttp://en.wikipedia.org/w/index.php?title=Transferrinhttp://en.wikipedia.org/w/index.php?title=Serum_ironhttp://en.wikipedia.org/w/index.php?title=Ferritinhttp://en.wikipedia.org/w/index.php?title=Erythrocyte_sedimentation_ratehttp://en.wikipedia.org/w/index.php?title=Erythropoiesishttp://en.wikipedia.org/w/index.php?title=Reticulocyte_production_indexhttp://en.wikipedia.org/w/index.php?title=Bone_marrowhttp://en.wikipedia.org/w/index.php?title=Reticulocyte


4/12

Anemia 4

Anemia

Reticulocyte production index

shows inadequate production

response to anemia.

Reticulocyte production index shows

appropriate response to anemia = ongoing

hemolysis or blood loss without RBC

production problem.

No clinical findings consistent

with hemolysis or blood loss:

pure disorder of production.

Clinical findings and abnormal

MCV: hemolysis or loss and

chronic disorder of production*.

Clinical findings and normal MCV= acute

hemolysis or loss without adequate time for

bone marrow production to compensate**.

Macrocytic anemia

(MCV>100)

Normocytic anemia

(80


5/12

Anemia 5

Microcytic

Microcytic anemia is primarily a result of hemoglobin synthesis failure/insufficiency, which could be caused by

several etiologies:

Heme synthesis defect

Iron deficiency anemia

Anemia of chronic disease (more commonly presenting as normocytic anemia)

Globin synthesis defect

alpha-, and beta-thalassemia

HbE syndrome

HbC syndrome

and various other unstable hemoglobin diseases

Sideroblastic defect

Hereditary sideroblastic anemia

Acquired sideroblastic anemia, including lead toxicity

Reversible sideroblastic anemiaIron deficiency anemia is the most common type of anemia overall and it has many causes. RBCs often appear

hypochromic (paler than usual) and microcytic (smaller than usual) when viewed with a microscope.

Iron deficiency anemia is caused by insufficient dietary intake or absorption of iron to replace losses from

menstruation or losses due to diseases.[16]

Iron is an essential part of hemoglobin, and low iron levels result in

decreased incorporation of hemoglobin into red blood cells. In the United States, 20% of all women of

childbearing age have iron deficiency anemia, compared with only 2% of adult men. The principal cause of iron

deficiency anemia in premenopausal women is blood lost during menses. Studies have shown that iron deficiency

without anemia causes poor school performance and lower IQ in teenage girls, although this may be due to

socioeconomic factors.[17]

[18]

Iron deficiency is the most prevalent deficiency state on a worldwide basis. Iron

deficiency is sometimes the cause of abnormal fissuring of the angular (corner) sections of the lips (angular

stomatitis).

Iron deficiency anemia can also be due to bleeding lesions of the gastrointestinal tract. Fecal occult blood testing,

upper endoscopy and lower endoscopy should be performed to identify bleeding lesions. In men and

post-menopausal women the chances are higher that bleeding from the gastrointestinal tract could be due to colon

polyp or colorectal cancer.

Worldwide, the most common cause of iron deficiency anemia is parasitic infestation (hookworm, amebiasis,

schistosomiasis and whipworm).[19]

Macrocytic

Megaloblastic anemia, the most common cause of macrocytic anemia, is due to a deficiency of either vitamin B12

,

folic acid (or both). Deficiency in folate and/or vitamin B12

can be due either to inadequate intake or insufficient

absorption. Folate deficiency normally does not produce neurological symptoms, while B12

deficiency does.

Pernicious anemia is caused by a lack of intrinsic factor. Intrinsic factor is required to absorb vitamin B12

from

food. A lack of intrinsic factor may arise from an autoimmune condition targeting the parietal cells (atrophic

gastritis) that produce intrinsic factor or against intrinsic factor itself. These lead to poor absorption of vitamin

B12

.

Macrocytic anemia can also be caused by removal of the functional portion of the stomach, such as during

gastric bypass surgery, leading to reduced vitamin B12

/folate absorption. Therefore one must always be aware

of anemia following this procedure.

Hypothyroidism
http://en.wikipedia.org/w/index.php?title=Gastric_bypasshttp://en.wikipedia.org/w/index.php?title=Hypothyroidismhttp://en.wikipedia.org/w/index.php?title=Hypothyroidismhttp://en.wikipedia.org/w/index.php?title=Gastric_bypasshttp://en.wikipedia.org/w/index.php?title=Intrinsic_factorhttp://en.wikipedia.org/w/index.php?title=Parietal_cellhttp://en.wikipedia.org/w/index.php?title=Autoimmunehttp://en.wikipedia.org/w/index.php?title=Pernicious_anemiahttp://en.wikipedia.org/w/index.php?title=Malabsorptionhttp://en.wikipedia.org/w/index.php?title=Malabsorptionhttp://en.wikipedia.org/w/index.php?title=Folic_acidhttp://en.wikipedia.org/w/index.php?title=Vitamin_B12http://en.wikipedia.org/w/index.php?title=Megaloblastic_anemiahttp://en.wikipedia.org/w/index.php?title=Trichuris_trichiurahttp://en.wikipedia.org/w/index.php?title=Schistosomiasishttp://en.wikipedia.org/w/index.php?title=Amebiasishttp://en.wikipedia.org/w/index.php?title=Hookwormhttp://en.wikipedia.org/w/index.php?title=Colorectal_cancerhttp://en.wikipedia.org/w/index.php?title=Polyp_%28medicine%29http://en.wikipedia.org/w/index.php?title=Polyp_%28medicine%29http://en.wikipedia.org/w/index.php?title=Colonoscopyhttp://en.wikipedia.org/w/index.php?title=Esophagogastroduodenoscopyhttp://en.wikipedia.org/w/index.php?title=Fecal_occult_bloodhttp://en.wikipedia.org/w/index.php?title=Gastrointestinal_tracthttp://en.wikipedia.org/w/index.php?title=Angular_stomatitishttp://en.wikipedia.org/w/index.php?title=Angular_stomatitishttp://en.wikipedia.org/w/index.php?title=IQhttp://en.wikipedia.org/w/index.php?title=Menstruationhttp://en.wikipedia.org/w/index.php?title=Ironhttp://en.wikipedia.org/w/index.php?title=Lead_poisoninghttp://en.wikipedia.org/w/index.php?title=Thalassemiahttp://en.wikipedia.org/w/index.php?title=Globinhttp://en.wikipedia.org/w/index.php?title=Anemia_of_chronic_diseasehttp://en.wikipedia.org/w/index.php?title=Iron_deficiency_anemiahttp://en.wikipedia.org/w/index.php?title=Heme


6/12

Anemia 6

Alcoholism commonly causes a macrocytosis, although not specifically anemia. Other types of liver disease can

also cause macrocytosis.

Methotrexate, zidovudine, and other drugs that inhibit DNA replication.

Macrocytic anemia can be further divided into "megaloblastic anemia" or "non-megaloblastic macrocytic anemia".

The cause of megaloblastic anemia is primarily a failure of DNA synthesis with preserved RNA synthesis, which

result in restricted cell division of the progenitor cells. The megaloblastic anemias often present with neutrophilhypersegmentation (610 lobes). The non-megaloblastic macrocytic anemias have different etiologies (i.e. there is

unimpaired DNA globin synthesis,) which occur, for example in alcoholism.

In addition to the non-specific symptoms of anemia, specific features of vitamin B12

deficiency include peripheral

neuropathy and subacute combined degeneration of the cord with resulting balance difficulties from posterior

column spinal cord pathology.[20]

Other features may include a smooth, red tongue and glossitis.

The treatment for vitamin B12

-deficient anemia was first devised by William Murphy who bled dogs to make them

anemic and then fed them various substances to see what (if anything) would make them healthy again. He

discovered that ingesting large amounts of liver seemed to cure the disease. George Minot and George Whipple then

set about to isolate the curative substance chemically and ultimately were able to isolate the vitamin B12

from the

liver. All three shared the 1934 Nobel Prize in Medicine.[21]

Normocytic

Normocytic anemia occurs when the overall hemoglobin levels are always increased, but the red blood cell size

(mean corpuscular volume) remains normal. Causes include:

Acute blood loss

Anemia of chronic disease

Aplastic anemia (bone marrow failure)

Hemolytic anemia

Dimorphic

When two or more causes of anemia act simultaneously, e.g., macrocytic hypochromic, due to hookworm infestation

leading to deficiency of both iron and vitamin B12

or folic acid[22]

or following a blood transfusion more than one

abnormality of red cell indices may be seen. Evidence for multiple causes appears with an elevated RBC distribution

width (RDW), which suggests a wider-than-normal range of red cell sizes.

Heinz body anemia

Heinz bodies form in the cytoplasm of RBCs and appear like small dark dots under the microscope. There are many

causes of Heinz body anemia, and some forms can be drug induced. It is triggered in cats by eating onions[23]

or

acetaminophen (paracetamol). It can be triggered in dogs by ingesting onions or zinc, and in horses by ingesting dryred maple leaves.
http://en.wikipedia.org/w/index.php?title=Acer_rubrumhttp://en.wikipedia.org/w/index.php?title=Zinchttp://en.wikipedia.org/w/index.php?title=Dogshttp://en.wikipedia.org/w/index.php?title=Acetaminophenhttp://en.wikipedia.org/w/index.php?title=Onionhttp://en.wikipedia.org/w/index.php?title=Cathttp://en.wikipedia.org/w/index.php?title=Heinz_bodyhttp://en.wikipedia.org/w/index.php?title=Blood_transfusionhttp://en.wikipedia.org/w/index.php?title=Folic_acidhttp://en.wikipedia.org/w/index.php?title=Vitamin_B12http://en.wikipedia.org/w/index.php?title=Ironhttp://en.wikipedia.org/w/index.php?title=Hookwormhttp://en.wikipedia.org/w/index.php?title=Hypochromichttp://en.wikipedia.org/w/index.php?title=Hemolytic_anemiahttp://en.wikipedia.org/w/index.php?title=Aplastic_anemiahttp://en.wikipedia.org/w/index.php?title=Anemia_of_chronic_diseasehttp://en.wikipedia.org/w/index.php?title=Hemorrhagehttp://en.wikipedia.org/w/index.php?title=Mean_corpuscular_volumehttp://en.wikipedia.org/w/index.php?title=Nobel_Prize_in_Physiology_or_Medicinehttp://en.wikipedia.org/w/index.php?title=Vitamin_B12http://en.wikipedia.org/w/index.php?title=George_Whipplehttp://en.wikipedia.org/w/index.php?title=George_Richards_Minothttp://en.wikipedia.org/w/index.php?title=William_Murphy_%28scientist%29http://en.wikipedia.org/w/index.php?title=Glossitishttp://en.wikipedia.org/w/index.php?title=Subacute_combined_degeneration_of_the_cordhttp://en.wikipedia.org/w/index.php?title=Peripheral_neuropathyhttp://en.wikipedia.org/w/index.php?title=Peripheral_neuropathyhttp://en.wikipedia.org/w/index.php?title=DNA_replicationhttp://en.wikipedia.org/w/index.php?title=Zidovudinehttp://en.wikipedia.org/w/index.php?title=Methotrexatehttp://en.wikipedia.org/w/index.php?title=Liver_diseasehttp://en.wikipedia.org/w/index.php?title=Macrocytosishttp://en.wikipedia.org/w/index.php?title=Alcoholism


7/12

Anemia 7

Hyperanemia

Hyperanemia is a severe form of anemia, in which the hematocrit is below 10%.

Refractory anemia

Refractory anemia is an anemia which does not respond to treatment.[24]

It is often seen secondary to

myelodysplastic syndromes.[25]

Iron deficiency anemia may also be refractory as a clinical manifestation of gastrointestinal problems which disrupt

iron metabolism.[26]

Causes

Broadly, causes of anemia may be classified as impaired red blood cell (RBC) production, increased RBC

destruction (hemolytic anemias), blood loss and fluid overload (hypervolemia). Several of these may interplay to

cause anemia eventually. Indeed, the most common cause of anemia is blood loss, but this usually doesn't cause any

lasting symptoms unless a relatively impaired RBC production develops, in turn most commonly by iron

deficiency.[27] (See Iron deficiency anemia)

Impaired production

Disturbance of proliferation and differentiation of stem cells.

Pure red cell aplasia[28]

Aplastic anemia,[28]

affecting all kinds of blood cells. Fanconi anemia is a hereditary disorder or defect

featuring aplastic anemia and various other abnormalities.

Anemia of renal failure,[28]

by insufficient erythropoietin production

Anemia of endocrine disorders

Disturbance of proliferation and maturation of erythroblasts Pernicious anemia

[28]is a form of megaloblastic anemia due to vitamin B

12deficiency dependent on impaired

absorption of vitamin B12

.

Anemia of folic acid deficiency.[28]

As with vitamin B12

, it causes megaloblastic anemia

Anemia of prematurity, by diminished erythropoietin response to declining hematocrit levels, combined with

blood loss from laboratory testing. It generally occurs in premature infants at 2 to 6 weeks of age.

Iron deficiency anemia, resulting in deficient heme synthesis[28]

thalassemias, causing deficient globin synthesis[28]

Congenital dyserythropoietic anemias, causing ineffective erythropoiesis

Anemia of renal failure[28]

(also causing stem cell dysfunction)

Other mechanisms of impaired RBC production

Myelophthisic anemia[28]

or myelophthisis is a severe type of anemia resulting from the replacement of bone

marrow by other materials, such as malignant tumors or granulomas.

Myelodysplastic syndrome[28]

anemia of chronic inflammation[28]
http://en.wikipedia.org/w/index.php?title=Chronic_inflammationhttp://en.wikipedia.org/w/index.php?title=Myelodysplastic_syndromehttp://en.wikipedia.org/w/index.php?title=Myelophthisishttp://en.wikipedia.org/w/index.php?title=Myelophthisic_anemiahttp://en.wikipedia.org/w/index.php?title=Renal_failurehttp://en.wikipedia.org/w/index.php?title=Congenital_dyserythropoietic_anemiahttp://en.wikipedia.org/w/index.php?title=Globin_synthesishttp://en.wikipedia.org/w/index.php?title=Thalassemiahttp://en.wikipedia.org/w/index.php?title=Heme_synthesishttp://en.wikipedia.org/w/index.php?title=Iron_deficiency_anemiahttp://en.wikipedia.org/w/index.php?title=Anemia_of_prematurityhttp://en.wikipedia.org/w/index.php?title=Megaloblastic_anemiahttp://en.wikipedia.org/w/index.php?title=Folic_acid_deficiencyhttp://en.wikipedia.org/w/index.php?title=Vitamin_B12http://en.wikipedia.org/w/index.php?title=Megaloblastic_anemiahttp://en.wikipedia.org/w/index.php?title=Pernicious_anemiahttp://en.wikipedia.org/w/index.php?title=Erythroblasthttp://en.wikipedia.org/w/index.php?title=Endocrine_disordershttp://en.wikipedia.org/w/index.php?title=Erythropoietinhttp://en.wikipedia.org/w/index.php?title=Renal_failurehttp://en.wikipedia.org/w/index.php?title=Fanconi_anemiahttp://en.wikipedia.org/w/index.php?title=Blood_cellhttp://en.wikipedia.org/w/index.php?title=Aplastic_anemiahttp://en.wikipedia.org/w/index.php?title=Pure_red_cell_aplasiahttp://en.wikipedia.org/w/index.php?title=Iron_deficiency_anemiahttp://en.wikipedia.org/w/index.php?title=Iron_deficiencyhttp://en.wikipedia.org/w/index.php?title=Iron_deficiencyhttp://en.wikipedia.org/w/index.php?title=Hypervolemiahttp://en.wikipedia.org/w/index.php?title=Hemolytic_anemiahttp://en.wikipedia.org/w/index.php?title=Human_iron_metabolismhttp://en.wikipedia.org/w/index.php?title=Iron_deficiency_anemiahttp://en.wikipedia.org/w/index.php?title=Myelodysplastic_syndromehttp://en.wikipedia.org/w/index.php?title=Therapy


8/12

Anemia 8

Increased destruction

Further information: Hemolytic anemia

Anemias of increased red blood cell destruction are generally classified as hemolytic anemias. These are generally

featuring jaundice and elevated LDH levels.

Intrinsic (intracorpuscular) abnormalities,[28]

where there the red blood cells have defects that cause premature

destruction. All of these, except paroxysmal nocturnal hemoglobinuria, are hereditary genetic disorders.[29]

Hereditary spherocytosis[28]

is a hereditary defect that results in defects in the RBC cell membrane, causing the

erythrocytes to be sequestered and destroyed by the spleen.

Hereditary elliptocytosis,[28]

another defect in membrane skeleton proteins

Abetalipoproteinemia,[28]

causing defects in membrane lipids

Enzyme deficiencies

Pyruvate kinase and hexokinase deficiencies,[28]

causing defect glycolysis

Glucose-6-phosphate dehydrogenase deficiency and glutathione synthetase deficiency,[28]

causing increased

oxidative stress

Hemoglobinopathies Sickle cell anemia

[28]

Hemoglobinopathies causing unstable hemoglobins[28]

Paroxysmal nocturnal hemoglobinuria[28]

Extrinsic (extracorpuscular) abnormalities

Antibody-mediated

Warm autoimmune hemolytic anemia is an anemia caused by autoimmune attack against red blood cells,

primarily by IgG. It is the most common of the autoimmune hemolytic diseases.[30]

It can be idiopathic, that

is, without any known cause, drug-associated or secondary to another disease such as systemic lupus

erythematosus, or a malignancy, such as chronic lymphocytic leukemia (CLL)

[31]

[31]

Cold agglutinin hemolytic anemia is primarily mediated by IgM. It can be idiopathic[32]

or result from an

underlying condition.

Rh disease,[28]

one of the causes of hemolytic disease of the newborn

Transfusion reaction to blood transfusions[28]

Mechanical trauma to red cells

Microangiopathic hemolytic anemias, including thrombotic thrombocytopenic purpura and disseminated

intravascular coagulation[28]

Infections, including malaria[28]

heart surgery

Blood loss

Anemia of prematurity from frequent blood sampling for laboratory testing, combined with insufficient RBC

production.

Trauma[28]

or surgery, causing acute blood loss

Gastrointestinal tract lesions,[28]

causing a rather chronic blood loss

Gynecologic disturbances,[28]

also generally causing chronic blood loss
http://en.wikipedia.org/w/index.php?title=Surgeryhttp://en.wikipedia.org/w/index.php?title=Physical_traumahttp://en.wikipedia.org/w/index.php?title=Anemia_of_prematurityhttp://en.wikipedia.org/w/index.php?title=Heart_surgeryhttp://en.wikipedia.org/w/index.php?title=Malariahttp://en.wikipedia.org/w/index.php?title=Disseminated_intravascular_coagulationhttp://en.wikipedia.org/w/index.php?title=Disseminated_intravascular_coagulationhttp://en.wikipedia.org/w/index.php?title=Thrombotic_thrombocytopenic_purpurahttp://en.wikipedia.org/w/index.php?title=Microangiopathic_hemolytic_anemiahttp://en.wikipedia.org/w/index.php?title=Blood_transfusionhttp://en.wikipedia.org/w/index.php?title=Transfusion_reactionhttp://en.wikipedia.org/w/index.php?title=Hemolytic_disease_of_the_newbornhttp://en.wikipedia.org/w/index.php?title=Rh_diseasehttp://en.wikipedia.org/w/index.php?title=Cold_agglutinin_hemolytic_anemiahttp://en.wikipedia.org/w/index.php?title=Chronic_lymphocytic_leukemiahttp://en.wikipedia.org/w/index.php?title=Systemic_lupus_erythematosushttp://en.wikipedia.org/w/index.php?title=Systemic_lupus_erythematosushttp://en.wikipedia.org/w/index.php?title=Idiopathichttp://en.wikipedia.org/w/index.php?title=Hemolysishttp://en.wikipedia.org/w/index.php?title=Autoimmune_diseaseshttp://en.wikipedia.org/w/index.php?title=Warm_autoimmune_hemolytic_anemiahttp://en.wikipedia.org/w/index.php?title=Antibodyhttp://en.wikipedia.org/w/index.php?title=Paroxysmal_nocturnal_hemoglobinuriahttp://en.wikipedia.org/w/index.php?title=Sickle_cell_anemiahttp://en.wikipedia.org/w/index.php?title=Hemoglobinopathieshttp://en.wikipedia.org/w/index.php?title=Oxidative_stresshttp://en.wikipedia.org/w/index.php?title=Glutathione_synthetasehttp://en.wikipedia.org/w/index.php?title=Glucose-6-phosphate_dehydrogenase_deficiencyhttp://en.wikipedia.org/w/index.php?title=Glycolysishttp://en.wikipedia.org/w/index.php?title=Hexokinasehttp://en.wikipedia.org/w/index.php?title=Pyruvate_kinasehttp://en.wikipedia.org/w/index.php?title=Abetalipoproteinemiahttp://en.wikipedia.org/w/index.php?title=Hereditary_elliptocytosishttp://en.wikipedia.org/w/index.php?title=Spleenhttp://en.wikipedia.org/w/index.php?title=Hereditary_spherocytosishttp://en.wikipedia.org/w/index.php?title=Genetic_disorderhttp://en.wikipedia.org/w/index.php?title=Paroxysmal_nocturnal_hemoglobinuriahttp://en.wikipedia.org/w/index.php?title=Lactate_dehydrogenasehttp://en.wikipedia.org/w/index.php?title=Jaundicehttp://en.wikipedia.org/w/index.php?title=Hemolytic_anemiahttp://en.wikipedia.org/w/index.php?title=Hemolytic_anemia


9/12

Anemia 9

Fluid overload

Fluid overload (hypervolemia) causes decreased hemoglobin concentration and apparent anemia:

General causes of hypervolemia include excessive sodium or fluid intake, sodium or water retention and fluid

shift into the intravascular space.[33]

Anemia of pregnancy is anemia that is induced by blood volume expansion experienced in pregnancy.

Treatments

Treatments for anemia depend on severity and cause.

Iron deficiency from nutritional causes is rare in men and post-menopausal women. The diagnosis of iron deficiency

mandates a search for potential sources of 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, it is very common to experience stomach upset and/or darkening

of the feces. 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.

Vitamin supplements given orally (folic acid) or intramuscularly (vitamin B-12) will replace specific deficiencies.

In anemia of chronic disease, anemia associated with chemotherapy, or anemia associated with renal disease, some

clinicians prescribe recombinant erythropoietin, epoetin alfa, to stimulate red-cell production.

In severe cases of anemia, or with ongoing blood loss, a blood transfusion may be necessary.

Blood transfusions

Doctors attempt to avoid blood transfusion in general, since multiple lines of evidence point to increased adverse

patient clinical outcomes with more intensive transfusion strategies. The physiological principle that reduction of

oxygen delivery associated with anemia leads to adverse clinical outcomes is balanced by the finding that transfusiondoes not necessarily mitigate these adverse clinical outcomes.

In severe, acute bleeding, transfusions of donated blood are often lifesaving. Improvements in battlefield casualty

survival is attributable, at least in part, to the recent improvements in blood banking and transfusion techniques.

Transfusion of the stable but anemic hospitalized patient has been the subject of numerous clinical trials.

Four randomized controlled clinical trials have been conducted to evaluate aggressive versus conservative

transfusion strategies in critically ill patients. All four of these studies failed to find a benefit with more aggressive

transfusion strategies.[34]

[35]

[36]

[37]

In addition, at least two retrospective studies have shown increases in adverse clinical outcomes in critically ill

patients that underwent more aggressive transfusion strategies.

[38]

[39]

Hyperbaric oxygen

Treatment of exceptional blood loss (anemia) is recognized as an indication for hyperbaric oxygen (HBO) by the

Undersea and Hyperbaric Medical Society.[40]

[41]

The use of HBO is indicated when oxygen delivery to tissue is not

sufficient in patients who cannot be transfused for medical or religious reasons. HBO may be used for medical

reasons when threat of blood product incompatibility or concern for transmissible disease are factors.[40]

The beliefs

of some religions (ex: Jehovah's Witnesses) may require they use the HBO method.[40]

In 2002, Van Meter reviewed the publications surrounding the use of HBO in severe anemia and found that all

publications report a positive result.[42]
http://en.wikipedia.org/w/index.php?title=Medical_journalhttp://en.wikipedia.org/w/index.php?title=Jehovah%27s_Witnesses_and_blood_transfusionshttp://en.wikipedia.org/w/index.php?title=Transmission_%28medicine%29http://en.wikipedia.org/w/index.php?title=Blood_producthttp://en.wikipedia.org/w/index.php?title=Religioushttp://en.wikipedia.org/w/index.php?title=Medicalhttp://en.wikipedia.org/w/index.php?title=Blood_transfusionhttp://en.wikipedia.org/w/index.php?title=Oxygenhttp://en.wikipedia.org/w/index.php?title=Undersea_and_Hyperbaric_Medical_Societyhttp://en.wikipedia.org/w/index.php?title=Hyperbaric_oxygenhttp://en.wikipedia.org/w/index.php?title=Clinical_trialshttp://en.wikipedia.org/w/index.php?title=Battlehttp://en.wikipedia.org/w/index.php?title=Blood_transfusionhttp://en.wikipedia.org/w/index.php?title=Epoetin_alfahttp://en.wikipedia.org/w/index.php?title=Erythropoietinhttp://en.wikipedia.org/w/index.php?title=Recombinant_proteinhttp://en.wikipedia.org/w/index.php?title=Cyanocobalaminhttp://en.wikipedia.org/w/index.php?title=Folic_acidhttp://en.wikipedia.org/w/index.php?title=Vitamin_Chttp://en.wikipedia.org/w/index.php?title=Ferrous_gluconatehttp://en.wikipedia.org/w/index.php?title=Ferrous_fumaratehttp://en.wikipedia.org/w/index.php?title=Iron%28II%29_sulfatehttp://en.wikipedia.org/w/index.php?title=Pregnancyhttp://en.wikipedia.org/w/index.php?title=Hypervolemiahttp://en.wikipedia.org/w/index.php?title=Hypervolemia


10/12

Anemia 10

References

[1] http://apps.who.int/classifications/apps/icd/icd10online/?gd50.htm+d50

[2] http://apps.who.int/classifications/apps/icd/icd10online/?gd60.htm+d64

[3] http://www.icd9data.com/getICD9Code.ashx?icd9=280

[4] http://www.icd9data.com/getICD9Code.ashx?icd9=285

[5] http://www.diseasesdatabase.com/ddb663.htm

[6] http://www.nlm.nih. gov/medlineplus/ency/article/000560.htm[7] http://www.emedicine.com/med/topic132.htm

[8] http://www.emedicine.com/emerg/topic808.htm#

[9] http://www.emedicine.com/emerg/topic734.htm#

[10] http://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?field=uid&term=D000740

[11] MedicineNet.com --> Definition of Anemia (http://www.medterms.com/script/main/art. asp?articlekey=15491) Last Editorial Review:

12/9/2000 8:31:00 AM

[12] merriam-webster dictionary --> anemia (http://www.merriam-webster.com/dictionary/anemia) Retrieved on May 25, 2009

[13] "eMedicineAnemia, Chronic : Article by Fredrick M Abrahamian, DO, FACEP" (http://www. emedicine.com/emerg/topic734.

htm#section~clinical). Emedicine.com. 2009-12-07. . Retrieved 2010-08-24.

[14] eMedicineHealth > anemia article (http://www.emedicinehealth.com/anemia/page3_em.htm) Author: Saimak T. Nabili, MD, MPH.

Editor: Melissa Conrad Stppler, MD. Last Editorial Review: 12/9/2008. Retrieved on 4 April 2009

[15] World Health Organization (2008). Worldwide prevalence of anaemia 19932005 (http://whqlibdoc.who. int/publications/2008/

9789241596657_eng. pdf). Geneva: World Health Organization. ISBN 9789241596657. . Retrieved 2009-03-25.

[16] Recommendations to Prevent and Control Iron Deficiency in the United States (http://www. cdc.gov/nccdphp/dnpa/nutrition/

nutrition_for_everyone/iron_deficiency/index.htm) MMWR 1998;47 (No. RR-3) p. 5

[17] Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG (2001). "Iron Deficiency and Cognitive Achievement Among

School-Aged Children and Adolescents in the United States".Pediatrics107 (6): 13811386. doi:10.1542/peds.107.6.1381. PMID 11389261.

[18] Grantham-McGregor S, Ani C (2001). "Iron-Deficiency Anemia: Reexamining the Nature and Magnitude of the Public Health Problem"

(http://jn. nutrition.org/content/131/2/649S.full).J Nutr131 (2): 649S668S. PMID 11160596. .

[19] "Iron Deficiency Anaemia: Assessment, Prevention, and Control: A guide for programme managers" (http://www.who.int/nutrition/

publications/en/ida_assessment_prevention_control.pdf) (PDF). . Retrieved 2010-08-24.

[20] eMedicineVitamin B-12 Associated Neurological Diseases : Article by Niranjan N Singh, MD, DM, DNB (http://www.emedicine.com/

NEURO/topic439.htm) July 18, 2006

[21] "Physiology or Medicine 1934Presentation Speech" (http://nobelprize.org/nobel_prizes/medicine/laureates/1934/press.html).

Nobelprize.org. 1934-12-10. . Retrieved 2010-08-24.

[22] "Dorlands Medical Dictionary" (http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.

jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_a_37zPzhtm). Mercksource.com. . Retrieved 2010-08-24.

[23] "Onions are Toxic to Cats" (http://www.peteducation.com/article. cfm?cls=0&cat=1763&articleid=1108). Peteducation.com. .

Retrieved 2010-08-24.

[24] MedTerms Definition: Refractory Anemia (http://www.medterms.com/script/main/art. asp?articlekey=5275)

[25] Good Source for later (http://atlasgeneticsoncology.org/Anomalies/RAID1104.html)

[26] Mody RJ, Brown PI, Wechsler DS (February 2003). "Refractory iron deficiency anemia as the primary clinical manifestation of celiac

disease" (http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1077-4114&volume=25&

issue=2&spage=169).J. Pediatr. Hematol. Oncol.25 (2): 16972. doi:10.1097/00043426-200302000-00018. PMID 12571473. .

[27] National Heart Lung and Blood Institute > What Causes Anemia? (http://www.nhlbi.nih. gov/health/dci/Diseases/anemia/

anemia_causes.html) Retrieved on June 9, 2010

[28] Table 12-1 in: Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.Robbins Basic Pathology. Philadelphia:Saunders. ISBN 1-4160-2973-7. 8th edition.

[29] Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007).Robbins Basic Pathology (8th ed.). Saunders Elsevier. p.

432 ISBN 978-1-4160-2973-1

[30] Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005).Robbins and Cotran

pathologic basis of disease. St. Louis, Mo: Elsevier Saunders. p. 637. ISBN 0-7216-0187-1.

[31] AUTOIMMUNE HEMOLYTIC ANEMIA (AIHA) (http://www.trcc.org/blood/10b_autoimmune.pdf) By J.L. Jenkins. The Regional

Cancer Center. 2001

[32] Berentsen S, Beiske K, Tjnnfjord GE (October 2007). "Primary chronic cold agglutinin disease: An update on pathogenesis, clinical

features and therapy" (http://www.informaworld.com/openurl?genre=article&doi=10.1080/10245330701445392&magic=pubmed&

#124;|1B69BA326FFE69C3F0A8F227DF8201D0).Hematology12 (5): 36170. doi:10.1080/10245330701445392. PMC 2409172.

PMID 17891600. .

[33] Page 62 (Fluid imbalances) in:Portable Fluids and Electrolytes (Portable Series) . Hagerstwon, MD: Lippincott Williams & Wilkins. 2007.

ISBN 1-58255-678-4.
http://www.informaworld.com/openurl?genre=article&doi=10.1080/10245330701445392&magic=pubmed||1B69BA326FFE69C3F0A8F227DF8201D0http://www.informaworld.com/openurl?genre=article&doi=10.1080/10245330701445392&magic=pubmed||1B69BA326FFE69C3F0A8F227DF8201D0http://www.trcc.org/blood/10b_autoimmune.pdfhttp://www.nhlbi.nih.gov/health/dci/Diseases/anemia/anemia_causes.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/anemia/anemia_causes.htmlhttp://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1077-4114&volume=25&issue=2&spage=169http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1077-4114&volume=25&issue=2&spage=169http://atlasgeneticsoncology.org/Anomalies/RAID1104.htmlhttp://www.medterms.com/script/main/art.asp?articlekey=5275http://www.peteducation.com/article.cfm?cls=0&cat=1763&articleid=1108http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_a_37zPzhtmhttp://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_a_37zPzhtmhttp://nobelprize.org/nobel_prizes/medicine/laureates/1934/press.htmlhttp://www.emedicine.com/NEURO/topic439.htmhttp://www.emedicine.com/NEURO/topic439.htmhttp://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdfhttp://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdfhttp://jn.nutrition.org/content/131/2/649S.fullhttp://www.cdc.gov/nccdphp/dnpa/nutrition/nutrition_for_everyone/iron_deficiency/index.htmhttp://www.cdc.gov/nccdphp/dnpa/nutrition/nutrition_for_everyone/iron_deficiency/index.htmhttp://whqlibdoc.who.int/publications/2008/9789241596657_eng.pdfhttp://whqlibdoc.who.int/publications/2008/9789241596657_eng.pdfhttp://www.emedicinehealth.com/anemia/page3_em.htmhttp://www.emedicine.com/emerg/topic734.htm#section~clinicalhttp://www.emedicine.com/emerg/topic734.htm#section~clinicalhttp://www.merriam-webster.com/dictionary/anemiahttp://www.medterms.com/script/main/art.asp?articlekey=15491http://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?field=uid&term=D000740http://www.emedicine.com/emerg/topic734.htm#http://www.emedicine.com/emerg/topic808.htm#http://www.emedicine.com/med/topic132.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000560.htmhttp://www.diseasesdatabase.com/ddb663.htmhttp://www.icd9data.com/getICD9Code.ashx?icd9=285http://www.icd9data.com/getICD9Code.ashx?icd9=280http://apps.who.int/classifications/apps/icd/icd10online/?gd60.htm+d64http://apps.who.int/classifications/apps/icd/icd10online/?gd50.htm+d50


11/12

Anemia 11

[34] Hbert PC, Wells G, Blajchman MA et al. (1999). "A multicenter, randomized, controlled clinical trial of transfusion requirements in critical

care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group".N. Engl. J. Med.340 (6): 40917.

doi:10.1056/NEJM199902113400601. PMID 9971864.

[35] Bush RL, Pevec WC, Holcroft JW (1997). "A prospective, randomized trial limiting perioperative red blood cell transfusions in vascular

patients".Am. J. Surg.174 (2): 1438. doi:10.1016/S0002-9610(97)00073-1. PMID 9293831.

[36] Bracey AW, Radovancevic R, Riggs SA et al. (1999). "Lowering the hemoglobin threshold for transfusion in coronary artery bypass

procedures: effect on patient outcome". Transfusion39 (10): 10707. doi:10.1046/j.1537-2995.1999.39101070.x. PMID 10532600.

[37] McIntyre LA, Fergusson DA, Hutchison JS et al. (2006). "Effect of a liberal versus restrictive transfusion strategy on mortality in patients

with moderate to severe head injury".Neurocritical care5 (1): 49. doi:10.1385/NCC:5:1:4. PMID 16960287.

[38] Corwin HL, Gettinger A, Pearl RG et al. (2004). "The CRIT Study: Anemia and blood transfusion in the critically illcurrent clinical

practice in the United States". Crit. Care Med.32 (1): 3952. doi:10.1097/01.CCM.0000104112.34142.79. PMID 14707558.

[39] ABC (Anemia and Blood Transfusion in Critical Care) Investigators, Baron JF, Reinhart K et al. (2002). "Anemia and blood transfusion in

critically ill patients".JAMA288 (12): 1499507. doi:10.1001/jama.288.12.1499. PMID 12243637.

[40] Undersea and Hyperbaric Medical Society. "Exceptional Blood Loss Anemia" (http://www.uhms.org/ResourceLibrary/Indications/

ExceptionalBloodLossAnemia/tabid/277/Default.aspx). . Retrieved 2008-05-19.

[41] Hart GB, Lennon PA, Strauss MB. (1987). "Hyperbaric oxygen in exceptional acute blood-loss anemia" (http://archive.

rubicon-foundation.org/4352).J. Hyperbaric Med2 (4): 205210. . Retrieved 2008-05-19.

[42] Van Meter KW (2005). "A systematic review of the application of hyperbaric oxygen in the treatment of severe anemia: an evidence-based

approach" (http://archive.rubicon-foundation.org/4038). Undersea Hyperb Med32 (1): 6183. PMID 15796315. . Retrieved 2008-05-19.

External links

National Anemia Action Council (http://www.anemia.org/) (USA)

Hemoglobin Calculator for Diagnosis of Anemia (http://www.etoolsage.com/Calculator/

Hemoglobin_Calculator.asp)
http://www.etoolsage.com/Calculator/Hemoglobin_Calculator.asphttp://www.etoolsage.com/Calculator/Hemoglobin_Calculator.asphttp://www.anemia.org/http://archive.rubicon-foundation.org/4038http://archive.rubicon-foundation.org/4352http://archive.rubicon-foundation.org/4352http://www.uhms.org/ResourceLibrary/Indications/ExceptionalBloodLossAnemia/tabid/277/Default.aspxhttp://www.uhms.org/ResourceLibrary/Indications/ExceptionalBloodLossAnemia/tabid/277/Default.aspx


12/12

Article Sources and Contributors 12

Article Sources and ContributorsAnemia Source: http://en.wikipedia.org/w/index.php?oldid=456064178 Contributors: 12637man, 27 Juni, 4wajzkd02, AHIMS INDIA, ARA, Abune, Adam.J.W.C., Addshore, AdjustShift,

Aechase1, Ahoerstemeier, Aidan Kehoe, Alansohn, Ale jrb, Alex.tan, Alison22, Allstarecho, Alpha Quadrant (alt), AmiDaniel, Andre Engels, Andy Dingley, Angr, Anonymous Dissident,

Antandrus, Arcadian, Arienh4, Arthur Albano, Auric, AussieJake, AxelBoldt, Axl, Axxaer, B, Balaji Ravichandran, Belovedfreak, Ben Ben, Bender235, Benji2, Bgtuc84, Bigdumbdinosaur, Bjb,

Bobbis, Bobo192, Bodnotbod, Booksrule9, Brandmeister (old), BritishWatcher, Brycechipmunk, CDrecche, CSZero, Cadwaladr, Caesarjbsquitti, Calmer Waters, Calvinchong, Camw, Can't

sleep, clown will eat me, CanadianLinuxUser, Capricorn42, Caps tiki, Casey56, Cenarium, Cereis, Cforrester101, Chaser, Cherubino, Chinesesurname, Chris Fookes, Chris Roy, Chris the speller,

Christian List, Chuunen Baka, Cleared as filed, Closedmouth, Coffee, ColdFusion650, CommonsDelinker, Cr299, Craigwwoods, CrazyGlu, Cvaneg, DMacks, DVD R W, DVMresearcher,

DVdm, DabMachine, Dacheatcode, Daniel Bonniot de Ruisselet, Danilot, Davidone, Davidruben, Dddstone, Deadk82, Decltype, Deflective, Denisarona, DerHexer, Diberri, Digitall565,Dimboukas, Dimketr, Dina, Dinesh smita, Dlohcierekim, Dmlevy 99, Doc.mari, Dogdocdvm, Dr.michael.benjamin, DrAlvi, Drgarden, Dysmorodrepanis, E. Sn0 =31337=, ESkog,

EdwardLockhart, Egil, Eliz81, Elygra, Enzo Aquarius, Epbr123, Erik9, Eshywiki, Everyking, Excirial, Fabiform, Falcon8765, Fieldday-sunday, Fleester, Flojesy, Flosseveryday, Fratrep, Fredrik,

Friday, Fuzzbox, Gamer007, Gene Hobbs, Generica, Gfirman en, Gilliam, Gilvala, Ginkgo100, GlobeGores, Gobbleswoggler, Gobonobo, Gogo Dodo, GreatWhiteNortherner, Green caterpillar,

Gurch, Gwalla, Hadal, Hallbrianh, Harold f, Hopping, Hoshin12, Hu12, IceUnshattered, Idont Havaname, Immunize, Imran, Inferno, Lord of Penguins, Infrangible, Invocatus, Iridescent, Ixfd64,

J.delanoy, JRHorse, JackLumber, Jaknouse, Jasonauk, Jclemens, Jeffhall318, JeffreyN, Jengod, Jfdwolff, Jfurr1981, Jh12, Jiang, Jkvandeusen, Jmh649, Jni, Jo Mengele, Joelloyd7, Joelmills,

Joewright, Johnnymadness, Jomunro, Jonathan.s.kt, Jossi, Jtdaugir, Juliancolton, Kalaiarasy, Kander, Kartano, Kateshortforbob, Kemfaye, Kendall35, Kimiko, Kindberg, King of Hearts, Kkailas,

Knutux, Koavf, Koyaanis Qatsi, Kpjas, Kubra, Kungfuadam, Kuru, Kyouketsusha, LAAFan, LB48Steve03, LIC Habeeb, La Pianista, Landon1980, Larschan, Lass Lethe, Latka, LeaveSleaves,

Lightmouse, Linzhoo2u, LittleOldMe, Lovepinkhore, Luboogers25, LuisEBenavente, Lycheeberries, MER-C, MK8, MONGO, Machn, Madhero88, Mamemimomundem, Mandarax, Mandy

Kaur, Mangoe, MastCell, Matdrodes, Mato, Maypigeon of Liberty, McSly, Mentifisto, Mgmei, Mikael Hggstrm, Miniyazz, MithrandirAgain, Moggie2002, Moss S, Mycroft7,

Mygerardromance, N5iln, Ndkartik, Neelix, Nephron, Neurolysis, Nick123, Nihiltres, Nmani77, Nmg20, NorthStarGirl, Notyoyoma, Nubzor, Nunh-huh, Nuujinn, Ohnoitsjamie, Okunderground,

Opelio, Oxymoron83, PMDrive1061, POVpushee, Papte, ParlerVousWiki, PatrikR, Peter.C, PhD Dre, Pharaoh of the Wizards, Philip Trueman, Pigman, PinchasC, Pne, Poccil, Polemyx,

Polihale, Postdlf, Puckly, Pzrmd, Queerbubbles, Quentonamos, Quibik, Raclemens, Radon210, Raul654, Ravensun, Redsox00002, Restepc, Reyps, Rich Farmbrough, Rjwilmsi, RobWBartel,

Rodrigotorres, Romanm, Ronz, RoshanMcG, Rsabbatini, RuM, SO-intO-yOuxX, SV Resolution, Saebjorn, Sassf, SchwarzeMelancholie, Scienceislife, Scientificone, Scohoust, ScottRaw,

Seanconway21, SeveredSpirit, Shadow4ARE, Shoeofdeath, SimonTrew, Sintesk7, Slgcat, Sliggy, Smith2267, Snowmanradio, Snoyes, Solon.KR, Some standardized rigour, Someone else,

Sp00n17, SpNeo, SpaceFlight89, Spiritia, Spitfire, Statkit1, Stephenb, Stevenfruitsmaak, Still relentless, Storkk, Sunray, Suougibma, Supertouch, Supten, Sushmav, Sweetie candykim,

Syncategoremata, Synchronism, TBAmes, TK-P, Tapanhp, Taquittee, Tarquin, Taxman, Techman224, Template namespace initialisation script, The High Fin Sperm Whale, The Master of

Mayhem, The Thing That Should Not Be, Thingg, Tiddly Tom, Tide rolls, Tom harrison, Tommy Bergin, Tommy2010, Tony K10, Touque, Tpbradbury, Trevor Andersen, Tristanb, Trsalmon,

Truddle, Twaz, Twsx, Uriah923, VashiDonsk, Vrenator, Wael El Kabbany, Wee Jimmy, WereSpielChequers, WhatamIdoing, Wiki wiki1, Wikibofh, Wikkipedia, Will314159, Windweilder,

Winston365, Wouterstomp, WriterHound, Yamitoyume, Yonghokim, Yudiweb, YuriSuassuna, Zackwhittaker, Zahid Abdassabur, Zerofenrir, 862 anonymous edits

Image Sources, Licenses and ContributorsFile:Anemia.JPG Source: http://en.wikipedia.org/w/index.php?title=File:Anemia.JPG License: Creative Commons Attribution-Sharealike 3.0 Contributors: James Heilman, MD

File:Loudspeaker.svg Source: http://en.wikipedia.org/w/index.php?title=File:Loudspeaker.svg License: Public Domain Contributors: J burns ternier, Jmh649

File:Symptoms of anemia.svg Source: http://en.wikipedia.org/w/index.php?title=File:Symptoms_of_anemia.svg License: Public Domain Contributors: Mikael Hggstrm

Image:Iron deficiency anemia.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Iron_deficiency_anemia.jpg License: Creative Commons Attribution-Sharealike 2.0 Contributors: E.

Uthman, MD

License

Creative Commons Attribution-Share Alike 3.0 Unported//creativecommons.org/licenses/by-sa/3.0/

Anemia Wikip

Documents

Transcript of Anemia Wikip