What should you know about severe anemia? Anemia - symptoms and treatment, causes, types, prevention What is moderate heart anemia.

An article on the topic: "severity of anemia by hemoglobin level. symptoms and treatment" from professionals.

Anemia is a decrease in the number of red blood cells in the blood - erythrocytes below 4.0x109 / l, or a decrease in hemoglobin below 130 g / l in men and below 120 g / l in women. Anemia during pregnancy is characterized by a decrease in hemoglobin below 110 g / l.

This is not an independent disease, anemia occurs as a syndrome in a number of diseases and leads to a disruption in the supply of oxygen to all organs and tissues of the body, which, in turn, provokes the development of many other diseases and pathological conditions.

Severity

Depending on the concentration of hemoglobin, it is customary to distinguish three degrees of severity of anemia:

• anemia of the 1st degree is recorded when the hemoglobin level decreases by more than 20% of the normal value;
• anemia of the 2nd degree is characterized by a decrease in hemoglobin by about 20-40% of the normal level;
• grade 3 anemia is the most severe form of the disease, when hemoglobin is reduced by more than 40% of the normal value.

It is unequivocal to show that the patient has 1 degree or a more severe stage can only be a blood test.

Causes

What it is: anemia, that is, anemia, is nothing more than a lack of hemoglobin in the blood. Namely, hemoglobin carries oxygen to all tissues of the body. That is, anemia is caused precisely by a lack of oxygen in the cells of all organs and systems.

1. The nature of nutrition. With insufficient intake of iron-containing foods, iron deficiency anemia can develop, this is more common in populations where there is already high level nutritional anemia;
2. Violation of the gastrointestinal tract (with violations of the absorption process). Since iron absorption occurs in the stomach and upper small intestine, in violation of the absorption process, the mucous membrane of the digestive tract, this disease develops.
3. Chronic blood loss (gastrointestinal bleeding, nosebleeds, hemoptysis, hematuria, uterine bleeding). Belongs to one of the most important causes of iron deficiency.

Iron-deficiency anemia

The most common form of anemia. It is based on a violation of the synthesis of hemoglobin (oxygen carrier) due to iron deficiency. It is manifested by dizziness, tinnitus, flies before the eyes, shortness of breath, palpitations. Dry skin, pallor are noted, jams and cracks appear in the corners of the mouth. Typical manifestations there are fragility and layering of nails, their transverse striation.

aplastic anemia

This is more often an acquired acute, subacute or chronic disease of the blood system, which is based on a violation of the hematopoietic function of the bone marrow, namely a sharp decrease in its ability to produce blood cells.

Sometimes aplastic anemia begins acutely and develops rapidly. But more often, the disease occurs gradually and does not show bright symptoms for quite a long time. The symptoms of aplastic anemia include all the symptoms that are characteristic of a lack of red blood cells, platelets and white blood cells in the blood.

B12 deficiency anemia

Occurs when there is a lack of vitamin B12 in the body, which is necessary for the growth and maturation of red blood cells in the bone marrow, as well as for correct operation nervous system. For this reason, one of the hallmark symptoms of B12 deficiency anemia is tingling and numbness in the fingers and a staggering gait.

Hemolysis occurs under the influence of antibodies. These can be maternal antibodies directed against the child's erythrocytes in case of incompatibility between the child and the mother for the Rh antigen and much less often for antigens of the ABO system. Antibodies against own erythrocytes can be active when normal temperature or only when cooled down.

They can appear for no apparent reason or in connection with the fixation on erythrocytes of incomplete haptens antigens alien to the body.

signs

We list the main signs of anemia that can disturb a person.

• pallor of the skin;
• increased heart rate and respiration;
• fast fatiguability;
• headache;
• dizziness;
• noise in ears;
• spots in the eyes;
• muscle weakness;
• difficulty concentrating;
• irritability;
• lethargy;
• slight rise in temperature.

Symptoms of anemia

Among the symptoms of anemia, manifestations directly related to hypoxia are considered leading. Degree clinical manifestations depends on the severity of the decrease in the number of hemoglobin.

1. With a mild degree (hemoglobin level 115-90 g / l), general weakness, increased fatigue, and a decrease in concentration may be observed.
2. With an average (90-70 g / l), patients complain of shortness of breath, palpitations, frequent headaches, sleep disturbance, tinnitus, loss of appetite, lack of sexual desire. Patients are characterized by pallor of the skin.
3. In the case of a severe degree (hemoglobin less than 70 g / l), symptoms of heart failure develop.

With anemia, symptoms in many cases do not manifest themselves. The disease can only be detected by laboratory blood tests.

Diagnosis of the disease

In order to understand how to treat anemia, it is important to determine its type and cause of development. The main method for diagnosing this disease is the study of the patient's blood.

The normal values ​​of the amount of hemoglobin in the blood are:

• for men 130-160 grams per liter of blood.
• for women 120-147 g/l.
• for pregnant women, the lower limit of the norm is 110gl.

Anemia treatment

Naturally, the methods of treating anemia radically differ depending on the type of anemia that caused its cause and severity. But the basic principle of treating anemia of any kind is the same - it is necessary to deal with the cause that caused the decrease in hemoglobin.

1. With anemia caused by blood loss, it is necessary to stop the bleeding as soon as possible. With a large blood loss that threatens life, a transfusion of donor blood is used.
2. For iron deficiency anemia, you should eat foods rich in iron, vitamin B12 and folic acid (they improve iron absorption and blood formation processes), the doctor may also prescribe medications containing these substances. Often folk remedies are effective.
3. In case of anemia provoked by infectious diseases and intoxication, it is necessary to treat the underlying disease, to carry out urgent measures to detoxify the body.

In the case of anemia, an important condition for treatment is healthy lifestyle life - proper balanced nutrition, alternation of loads and rest. It is also necessary to avoid contact with chemical or poisonous substances and oil products.

Nutrition

An important component of the treatment is a diet with foods rich in substances and trace elements that are necessary for the process of hematopoiesis. What foods should be eaten with anemia in a child and an adult? Here is the list:

• meat, sausages;
• offal - especially the liver;
• fish;
• egg yolks;
• whole grain flour products;
• seeds - pumpkin, sunflower, sesame;
• nuts - especially pistachios;
• spinach, cabbage, Brussels sprouts, fennel, parsley leaves;
• beet;
• black currant;
• sprouts, wheat germ;
• apricots, prunes, figs, dates;

Drinks containing caffeine (eg, tea, coffee, cola) should be avoided, especially with meals, as caffeine interferes with iron absorption.

Iron supplements for anemia

Iron preparations for anemia are much more effective. The absorption of this trace element in the digestive tract from iron preparations is 15-20 times higher than from food.

This allows you to effectively use iron supplements for anemia: raise hemoglobin faster, restore iron stores, eliminate general weakness, fatigue and other symptoms.

1. Ferretab composite (0154g ferrous fumarate and 0.0005g folic acid). Additionally, it is desirable to take ascorbic acid in a daily dose of 0.2-0.3 g).
2. Sorbifer durules (0.32 g of ferrous sulfate and 0.06 g of vitamin C) is available in dragee daily dosage depending on the degree of anemia 2-3 times a day.
3. Totem - is available in bottles of 10 milliliters, the content of the elements is the same as in the sorbifer. It is used orally, it can be diluted with water, it is possible to prescribe it for intolerance to tablet forms of iron. Daily dose 1-2 doses.
4. Fenyuls (0.15g, ferrous sulfate, 0.05g vitamin C, vitamins B2, B6, 0.005g calcium pantothenate.
5. Vitamin B12 in 1 ml ampoules 0.02% and 0.05%.
6. Folic acid tablets 1mg.
7. Ampoule preparations of iron, for intramuscular and intravenous administration, are sold only by prescription and require injections only in stationary conditions due to the high frequency of allergic reactions to these drugs.

You can not take iron supplements in conjunction with drugs that reduce their absorption: Levomycitin, Calcium preparations, Tetracyclines, Antacids. As a rule, iron preparations are prescribed before meals, if there is no vitamin C in the drug, then an additional intake of ascorbic acid in a daily dose of 0.2-0.3 g is required.

For each patient, the daily need for iron is specially calculated, as well as the duration of the course of treatment, the absorption of the specific prescribed drug and the iron content in it are taken into account. Long-term courses of treatment are usually prescribed, within 1.5-2 months are taken therapeutic doses, and in the next 2-3 months - prophylactic.

Consequences

Iron-deficiency anemia, not treated at an early stage, can have serious consequences. A severe degree turns into heart failure, associated with tachycardia, edema, decreased blood pressure. Sometimes people end up in the hospital with a sharp loss of consciousness, the cause of which is undertreated or not detected in time anemia.

Therefore, if you suspect that you have this disease or are prone to low hemoglobin, then it is worth taking a control blood test every three months.

or a reduced amount

hemoglobin

in the blood, and colloquially - "anemia". Almost every person has come across such a formulation at least once, especially women. What does this frightening term mean? Why does this state of the body occur? Why is anemia dangerous? How to recognize it in time at the initial stages?

Anemia- this is a pathological condition of the body, in which there is a decrease in the amount of hemoglobin and erythrocytes below the lower limits of the norm. Moreover, a decrease in hemoglobin content is a mandatory sign of anemia, in contrast to a decrease in the number of red blood cells. That is, there is always a decrease in the concentration of hemoglobin in anemia, but there may not be a decrease in the number of red blood cells. However, in some cases, with anemia, pathological forms of erythrocytes are detected (not doubly - concave).

Anemia is not an independent disease, but a consequence of the underlying pathology, therefore, the detection of a reduced level of red blood cells and hemoglobin requires a thorough diagnosis to identify the cause!

What is pseudoanemia and occult anemia? Anemia must be distinguished from the following conditions of the body:

Hydremia is blood thinning. This condition is possible when tissue fluid enters the bloodstream during the convergence of edema, heavy drinking. Hydremia is pseudoanemia.

Blood clots Blood clotting can occur due to the loss of the liquid part of the blood, which occurs with severe dehydration. Dehydration occurs as a result of severe vomiting, diarrhea, profuse sweating. However, in this case, due to blood clotting, the amount of hemoglobin and erythrocytes may be within normal values. In such situations, one speaks of latent anemia.

Specific and non-specific signs of anemia - what applies to them? First of all, let's look at how anemia manifests itself. There are non-specific manifestations and specific ones. Non-specific manifestations are called so because these signs are common to all types of anemia. Specific the manifestations are strictly individual and characteristic only for each specific type of anemia. Now we will consider only non-specific manifestations, and we will indicate the specific ones when considering the types of anemia.

Symptoms and signs of anemia So to nonspecific signs of anemia include the following symptoms:

• pale skin and mucous membranes
• weakness
• dizziness
• noise in ears
• headache
• fast fatiguability
• drowsiness
• dyspnea
• anorexia (abnormal loss of appetite or aversion to food)
• sleep disturbance
• menstrual disorders up to the complete cessation of menstruation (amenorrhea)
• impotence
• tachycardia (increased heart rate)
• murmurs in the heart (increased heart beat, systolic murmur at the apex of the heart)
• heart failure
• with a decrease in the amount of hemoglobin less than 50 g / l, the development of acidosis (acidification of the blood) is possible
• decrease in hemoglobin content below normal levels
• decrease in the content of red blood cells below normal
• color index change
• changes in the content of leukocytes and platelets

Types of anemia - posthemorrhagic, hemolytic, deficient and hypoplastic Anemia can be caused completely different reasons, therefore, it is customary to divide all anemias according to various criteria, including the reasons that cause them. According to the causes (pathogenesis), three types of anemia are distinguished: posthemorrhagic, hemolytic and associated with impaired blood formation (deficient and hypoplastic). What does it mean? Let's take a closer look.

Posthemorrhagic anemia associated with acute or chronic blood loss (bleeding, injury).

Hemolytic- develop in connection with the increased destruction of erythrocytes.

Deficiency anemia are caused by a lack of vitamins, iron or other trace elements that are necessary for hematopoiesis.

Hypoplastic anemia- This is the most severe type of anemia and it is associated with impaired hematopoiesis in the bone marrow.

Degrees of anemia In addition to this classification of anemia according to pathogenesis, several others are used, which are called working classifications of anemia, since they are guided by them. practitioners- clinicians. Consider this group of working classifications:

1. By severity. There are three degrees of severity of anemia - mild, moderate and severe, depending on the content of hemoglobin and red blood cells in the blood:

1. By color index (CPU) blood distinguish between normochromic (CP - 0.8-1.05) anemia, hyperchromic (CP> 1.05) and hypochromic (CP folic acid); hypochromic anemias include iron deficiency anemia, thalassemia and chronic posthemorrhagic anemia.

1. According to the average diameter of erythrocytes(SDE) distinguish between normocytic anemia (SDE = 7.2 - 8.0 microns), microcytic (SDE), macrocytic (SDE > 8.0 microns) and megaloblastic (SDE > 9.5 microns). Normocytic anemias are characterized by normal erythrocyte diameter, microcytic anemias are characterized by a reduced erythrocyte diameter, and macrocytic and megaloblastic anemias are associated with an increase in erythrocyte diameter. Normocytic anemias include acute posthemorrhagic and most hemolytic anemias; to microcytic - iron deficiency anemia, microspherocytosis and chronic posthemorrhagic anemia. Macrocytic anemia is a hemolytic disease of the newborn, folic deficiency anemia. Megalocytic - B12 deficiency anemia.

1. Serum iron content There are normosidermic anemia (the content of iron in the blood serum is normal 9.0 - 31.3 μmol / l), hyposideremic (the iron content is reduced to less than 9.0 μmol / l) and hypersideremic (the iron concentration is increased more than 32 μmol / l). Normosideremic anemia is an acute posthemorrhagic anemia; hyposideremic is iron deficiency anemia, thalassemia and chronic posthemorrhagic; hypersideremic are hemolytic anemias and B12 are deficient.

We examined what types, and on what grounds anemia is classified. Let's move on to consider how certain types of anemia manifest themselves, what changes are observed in the blood and in the human body as a whole. Posthemorrhagic anemia, symptoms, diagnosis and treatment Posthemorrhagic anemia can be acute or chronic. Acute posthemorrhagic anemia develops in response to transient and large blood loss, and chronic - develops in response to prolonged blood loss in small amounts.

Symptoms of acute posthemorrhagic anemia, blood picture Symptoms of acute posthemorrhagic anemia are such signs: pallor, severe dizziness, fainting, rapid pulse, cold sweat, decrease in body temperature, sometimes vomiting. Blood loss greater than 30% of baseline is critical and life-threatening.

Diagnosis of posthemorrhagic acute anemia In the blood, the number of reticulocytes increases by more than 11%, "immature" erythrocytes and erythrocytes with a changed cell shape also appear. On the part of leukocytes, there is an increase in their total number above 12 G/l, and in the leukocyte formula there is a shift to the left. In the next two months after acute blood loss, the indicators of erythrocytes and hemoglobin are restored. However, the restoration of the number of erythrocytes and hemoglobin content is associated with the expenditure of the iron fund in the body and may lead to the development of iron deficiency. Therefore, during the recovery period after blood loss, appropriate nutrition is necessary, that is, the diet should contain foods with high content iron (for example, pomegranates, buckwheat, liver, etc.).

Principles of treatment of acute posthemorrhagic anemia Treatment of acute posthemorrhagic anemia should be carried out in a hospital and should be aimed at restoring the amount of circulating blood, the number of blood cells and maintaining these indicators. The first step is to stop the bleeding. Then, depending on the amount of blood loss, blood transfusion, erythrocyte mass and blood substitutes are used.

Symptoms of chronic posthemorrhagic anemia The symptoms of chronic posthemorrhagic anemia are the same as those of iron deficiency anemia. What are these symptoms? So, the signs of chronic post-hemorrhagic anemia are: skin of an “alabaster” shade (very white, pale), perversion of smell (intolerance to odors or, conversely, craving for any odors), change in taste, puffiness of the face, pastosity of the shins, brittle hair and nails , dryness, roughness of the skin. Education is also possible koilonechius- thinned and flattened nails. In addition to these external signs, shortness of breath, nausea, dizziness, increased heart rate, weakness, fatigue, subfebrile temperature (up to 37 ° C) and so on may occur. Due to iron deficiency, disorders of the gastrointestinal tract- caries, glossitis, reduced acidity of gastric juice, as well as involuntary urination with laughter, sweating.

Diagnosis of chronic posthemorrhagic anemia In the blood with chronic posthemorrhagic anemia, weakly stained small erythrocytes, oval erythrocytes appear, the total number of leukocytes is reduced, and a slight lymphocytosis is observed in the leukocyte formula. In the blood serum, the concentration of iron is below the norm - 9.0 μmol / l, the content of copper, calcium, vitamins A, B, C is also below the normal level, but, however, the concentration of zinc, manganese and nickel in the blood is increased.

Causes of chronic posthemorrhagic anemia Why does such a condition occur - chronic posthemorrhagic anemia? The reasons for this phenomenon are as follows:

• diseases of the gastrointestinal tract (ulcers, polyps, hernias)
• helminthiases (roundworms)
• tumors
• kidney disease
• liver disease (cirrhosis, liver failure)
• uterine bleeding
• blood clotting disorders

Treatment of chronic posthemorrhagic anemia It is precisely because of the reasons leading to the development of chronic posthemorrhagic anemia that in the treatment of this condition, first of all, it is necessary to eliminate the cause of chronic blood loss. Then a balanced diet containing foods high in iron, folic acid and vitamins is necessary. In case of severe anemia, it is necessary to take iron preparations (sorbifer, ferrum-lek) in the form of tablets or injections, folic acid preparations, vitamin B12 in the form of tablets or injections. The most effective preparations for restoring the level of iron in the body are tablet preparations, which are produced by various companies. Because of this, pharmacies offer a wide selection of iron preparations.

When choosing a drug, it is necessary to pay attention to the iron content in one tablet and the bioavailability of this drug. Iron preparations must be taken together with ascorbic acid and folic acid, since in such a combination the best absorption of iron occurs. However, when choosing a drug and dose, it is imperative to consult a doctor.

Hemolytic anemia, symptoms, diagnosis and treatment Causes of hemolytic anemia Hemolytic anemias are a group of anemias in which the processes of destruction of red blood cells prevail over the processes of their production. In other words, the destruction of red blood cells occurs faster than new cells are formed to replace the destroyed ones. Hemolytic anemia can be hereditary or acquired.

Hereditary hemolytic anemias This:

1. Minkowski-Choffard anemia (hereditary microspherocytosis)
2. anemia with enzyme deficiency (glucose - 6 phosphate dehydrogenase)
3. sickle cell anemia
4. thalassemia

Symptoms of hemolytic anemia A common feature of all hemolytic anemias is jaundice. Jaundice appears due to the fact that during the destruction of red blood cells a large amount of bilirubin is released into the blood, which leads to this symptom. In addition to jaundice, there are the following signs common to all hemolytic anemias - an increase in the liver and spleen, an increase in the concentration of bilirubin in the blood, dark color urine and feces, fever, chills, pain, urine of the color of "meat slops".

Due to the fact that sickle cell anemia and thalassemia are the most widespread among hereditary hemolytic anemias, we will consider them in more detail.

Sickle cell anemia, causes, symptoms, diagnosis Causes of sickle cell anemia

sickle cell anemia caused by the fact that a hemoglobin molecule with a defect is synthesized. Such defective hemoglobin molecules assemble into spindle-shaped crystals ( tactoids), which stretch the erythrocyte, giving it a crescent shape. Such sickle-shaped erythrocytes have little plasticity, increase blood viscosity and clog small blood vessels. In addition, with their sharp ends, such red blood cells pierce each other and are destroyed.

Symptoms of sickle cell anemia Sickle cell anemia is externally manifested by the following symptoms:

• hemolytic crises, which are provoked by a lack of oxygen (for example, in the mountains on high altitude or in an unventilated area with a large crowd of people)
• jaundice
• painful swelling and ulcers on the lower extremities
• hemoglobin in urine
• enlarged spleen
• visual impairment

Diagnosis of sickle cell anemia In the blood test, a reduced amount of hemoglobin (50 - 80 g / l) and erythrocytes (1 - 2 T / l), an increase in reticulocytes up to 30% or more. The blood smear shows crescent-shaped erythrocytes and erythrocytes with Jolly bodies and Cabot rings.

Treatment of sickle cell anemia The main principle of treatment of this type of anemia is the prevention of hemolytic crises. This effect is achieved by the fact that a person avoids hypoxic conditions - the presence in rarefied air, in places with a low oxygen content, and so on. Use a transfusion of red blood cells or blood substitutes.

Thalassemia - causes, symptoms, diagnosis of the disease

Thalassemia - causes of the disease Thalassemia occurs due to a violation of the rate of formation of hemoglobin. Such immature hemoglobin is not stable, as a result of which it falls out in erythrocytes in the form of inclusions - bodies, and the entire erythrocyte acquires the appearance of a target cell. Thalassemia is a severe hereditary disease, which cannot be cured, but you can only alleviate its manifestations.

Symptoms of thalassemia

• pale, icteric skin
• skull deformity
• physical and mental underdevelopment
• Mongoloid eye shape
• bone structure disorders that are visible on x-rays
• enlargement of the liver and spleen
• hemosiderosis, due to which the skin acquires an earthy - green hue

Diagnosis of thalassemia Target erythrocytes, an increased number of reticulocytes, a decrease in hemoglobin concentration to 20 g / l, and erythrocytes to 1 T / l are found in the blood. There is also a decrease in the number of leukocytes and platelets.

Unfortunately,

treatment thalassemia is not amenable and it is only possible to alleviate its course. For this purpose, a transfusion of red blood cells or blood substitutes is used.

So, we examined the main types of hereditary hemolytic anemia, which are transmitted from parents to children. Let's move on to the consideration of acquired hemolytic anemia, which arise due to the presence of a provoking factor.

Acquired hemolytic anemia, immune and non-immune anemia First of all, it should be noted that acquired hemolytic anemia can develop with the participation immune system(immune) or without its participation (non-immune). Anemias that develop with the participation of the immune system include viral, syphilitic anemia and hemolytic disease of the newborn. - this is the Marchiafava-Michelli disease, as well as anemia resulting from long marching, poisoning with alcohol, acids, salts heavy metals, poisons of snakes, insects and mushrooms. With burns that make up more than 20% of the body surface, a lack of vitamin E and malaria, non-immune hemolytic anemia also develops.

Syphilitic and viral immune hemolytic anemia

Treatment these types of anemia are usually not required.

Hemolytic disease of the newborn, causes of development, symptoms of the disease, severity.

Hemolytic disease of the newborn- a disease that occurs as a result of a conflict between the red blood cells of a mother and a child that have incompatible blood group antigens or

rhesus factor

In this case, the mother's antibodies penetrate the placenta to the fetus and cause the destruction of red blood cells in the child. The severity of hemolytic disease of the newborn depends on the amount of maternal antibodies that cross the placenta to the fetus. Therefore, pregnant women with a negative

- a blood factor regularly take a blood test for the presence of just such antibodies. If antibodies are found, then appropriate treatment is needed. A child with hemolytic disease of the newborn is born with

edema ascites

It has a high cry tone and a high content of immature erythrocytes (erythroblasts, normocytes and reticulocytes). Hemolytic disease of the newborn is classified by severity into mild, moderate and severe according to the amount of hemoglobin and bilirubin in the blood.

Currently underway

prevention hemolytic disease of the newborn by monitoring the presence of antibodies in the mother. If antibodies are detected in the mother, then treatment is carried out in a hospital. In this case, an infusion of anti-Rhesus immunoglobulins is performed.

Signs of non-immune hemolytic anemias, laboratory symptomsNon-immune hemolytic anemias have the following symptoms - jaundice, enlarged liver and spleen, increased concentration of bilirubin in the blood, dark color of urine and feces, fever, chills, pain, urine of the color of "meat slops". The blood picture shows the presence of red blood cells of various shapes and sizes, reticulocytosis up to 30 % and above, a reduced number of leukocytes and platelets. Such anemias themselves do not require a separate and special treatment. treatment, since first of all it is necessary to remove the factor that causes this anemia (venoms of snakes, salts of heavy metals, etc.).

Anemias caused by impaired blood formation are divided into two large groups - deficiency anemia and hypoplastic. Deficiency anemia is associated with a deficiency of elements necessary for hematopoiesis. TO deficiency anemia include iron deficiency anemia, iron refractory anemia, B12 deficiency and folic deficiency. Hypoplastic anemias are caused by the death of progenitor cells in the bone marrow. Hypoplastic anemia can be hereditary (Fanconi anemia, Estren-Dameshik anemia, Blackfairn-Diamond anemia) and acquired. Acquired hypoplastic anemias develop either by themselves due to an unknown cause, or against the background of an existing disease - radiation sickness, infections, damage to the immune system.

For most people, of greater interest are deficiency anemia, which can occur in almost every person. Therefore, we will dwell in more detail on this type of anemia.

Iron-deficiency anemia– causes, symptoms, diagnosis and treatment

The content of iron in the human body is 4-5 g or 0.000065% of body weight. Of these, 58% of iron is part of hemoglobin. Iron can be deposited (deposited in reserve) in the liver, spleen and bone marrow. At the same time, there is a physiological loss of iron with feces, urine, sweat, menstruation and during breastfeeding, so it is necessary to include iron-containing foods in the diet.

Causes of iron deficiency anemia Iron deficiency anemia occurs when:

1. lack of iron in the body (premature babies, children under 1 year old, pregnant women)
2. increased need for iron (pregnancy, breastfeeding, period of increased growth)
3. disorders of iron absorption from the gastrointestinal tract and its subsequent transportation
4. chronic blood loss

Symptoms of iron deficiency anemia Clinically, iron deficiency anemia is manifested by three main syndromes - hypoxic, sideropenic and anemic. What are these syndromes? What characterizes each of them? A syndrome is a stable set of symptoms. So, the hypoxic syndrome is characterized by shortness of breath, headaches, tinnitus, fatigue, drowsiness and tachycardia; anemic syndrome is expressed in a decrease in the content of the number of erythrocytes and hemoglobin. Sideropenic syndrome is directly related to a decrease in the amount of iron in the body and manifests itself as follows: malnutrition of the skin, nails, hair - skin of an "alabaster" shade, dryness and roughness of the skin, brittle hair and nails. Then the perversion of taste and smell joins (the desire to eat chalk, inhale the smell of washed concrete floors, etc.). There may be complications from the gastrointestinal tract - caries, dysphagia, decreased acidity of gastric juice, involuntary urination (in severe cases), sweating.

Diagnosis of iron deficiency anemia In the blood, there is a decrease in the content of hemoglobin to 60 - 70 g / l, erythrocytes to 1.5 - 2 T / l, the number of reticulocytes is also reduced or completely absent. Red blood cells of various shapes and sizes appear. The serum iron concentration is below normal.

Treatment of iron deficiency anemia

The treatment of iron deficiency anemia is based on the principles of eliminating the cause of its occurrence - the treatment of diseases of the gastrointestinal tract, as well as the introduction of a balanced diet. The diet should contain foods high in iron (liver, meat, milk, cheese, eggs, cereals, etc.). However, iron preparations are the main means of restoring the amount of iron in the body at the initial stage. In most cases, these drugs are prescribed in the form of tablets. In severe cases, resort to intramuscular or intravenous injections. In the treatment of this anemia, for example, such drugs are used: sorbifer, ferrum-lek, tardiferon, totem and others. Choice of different medicines, including combined ones, is very wide.

When choosing, you should consult with your doctor. Usually, the daily dose for the prevention and treatment of anemia mild degree is 50-60 mg of iron, for the treatment of moderate anemia - 100-120 mg of iron per day. Treatment of severe anemia is carried out in a hospital and iron preparations are used in the form of injections. Then they switch to tablet forms. Iron preparations cause dark stools, but this is normal in this situation. If an iron preparation causes discomfort in the stomach, it must be replaced.

Iron refractory anemia causes, symptoms, diagnosis and treatment

Cause of iron refractory anemia Iron refractory anemia is also called sideroblastic or sideroachristic anemia. Iron refractory anemia develops against the background of normal iron content in the blood serum and a lack of enzymes that are involved in the synthesis of hemoglobin. That is, the main cause of iron refractory anemia is a violation of the processes of "assimilation" of iron.

Symptoms of iron refractory anemia, what is hemosiderosis? Iron refractory anemia is manifested by shortness of breath, headaches, dizziness, tinnitus, fatigue, drowsiness, sleep disturbances and tachycardia. Due to the high content of iron in the blood, tissues are observed hemosiderosis.Hemosiderosis is the deposition of iron in organs and tissues due to its excess. With hemosiderosis, insufficiency of the cardiovascular system develops due to the deposition of iron in the heart muscle, diabetes mellitus, lung damage, and the size of the liver and spleen increase. The skin becomes earthy.

Diagnosis of iron refractory anemia, what are sideroblasts? The color index of blood is reduced to 0.6 - 0.4, erythrocytes of various shapes and sizes are present, the amount of hemoglobin and erythrocytes is below normal. There are also changes in the bone marrow - cells appear - sideroblasts. Sideroblasts are cells that have a corolla of iron around the nucleus. Normally, such cells in the bone marrow are 2.0 - 4.6%, and with iron refractory anemia, their number can reach up to 70%.

Treatment of iron refractory anemia There is currently no treatment that can eliminate it completely. It is possible to use replacement therapy - the infusion of red blood cells and blood substitutes.

B12 deficiency anemia, causes of the disease, diagnosis and treatment.

What is B12? Where is this vitamin found? First, what is B12? AT 12 is a vitamin that also has the name cyanocobalamin. Cyanocobalamin is found mainly in animal products - meat, liver, kidneys, milk, eggs, cheese. The level of vitamin B12 must be constantly maintained by the use of appropriate foods, since its natural physiological losses occur with feces and bile.

Causes of B12 deficiency anemia So, B12 deficiency anemia is an anemia that occurs due to vitamin B12 deficiency. A lack of vitamin B12 can be caused by insufficient intake from food or a violation of its absorption in the gastrointestinal tract. Insufficient intake of cyanocobalamin with food is possible in strict vegetarians. Also, a lack of B12 can manifest itself with an increase in the need for it in pregnant women, nursing mothers, and cancer patients. Failure to assimilate vitamin B12, supplied with food in sufficient quantities, occurs with diseases of the stomach, small intestine(diverticulum, worms) and treatment with anticonvulsants or oral contraceptives.

Symptoms of B12 deficiency anemia Symptoms of manifestation of B12 - deficiency anemia are characterized by disturbances in the central nervous system and the gastrointestinal tract. So, consider these two large groups of symptoms:

1. from the central nervous system. There is a decrease in reflexes, paresthesia (“goosebumps”), numbness of the limbs, a feeling of cottony legs, gait disturbance, memory loss
2. from the gastrointestinal tract. There is an increased sensitivity to acidic foods, glossitis, difficulty swallowing, atrophy of the gastric mucosa, an increase in the size of the liver and spleen

Diagnosis of B12 deficiency anemia In the blood system, there is a transition to the megaloblastic type of hematopoiesis. This means that giant erythrocytes with a shortened life span, brightly colored erythrocytes without enlightenment in the center, pear-shaped and oval erythrocytes with Jolly bodies and Kabo rings appear in the blood. Giant neutrophils also appear, the number of eosinophils decreases (up to total absence), basophils, and total leukocyte count. In the blood, the concentration of bilirubin is increased, and therefore, slight yellowness of the skin and sclera of the eyes can be observed.

Treatment of B12 deficiency anemia First of all, it is necessary to cure diseases of the gastrointestinal tract and establish a balanced diet, with a sufficient content of vitamin B12. The use of a course of vitamin B12 injections quickly normalizes hematopoiesis in the bone marrow, and then a constant, regular intake of a sufficient amount of vitamin B12 with food is necessary.

Folate deficiency anemia, causes, symptoms and treatment Vitamin B9 - folic acid. It enters the body with food - beef and chicken liver, lettuce, spinach, asparagus, tomatoes, yeast, milk, meat. Vitamin B9 is able to accumulate in the liver. Thus, B9 - deficiency anemia occurs due to a lack of folic acid in the human body. Folic acid deficiency is possible when feeding children goat milk, with a long heat treatment food, in vegetarians, with insufficient or unbalanced nutrition. Also, folic acid deficiency is observed with an increased need for it in pregnant, lactating, premature babies, adolescents, and cancer patients. Sun - deficiency anemia is caused by the presence of such diseases as chronic renal failure, liver disease. The occurrence of folic acid deficiency is also possible with malabsorption this vitamin what happens with alcoholism, taking oral contraceptives and B12 deficiency.

Symptoms of folate deficiency anemia With folic deficiency anemia, the gastrointestinal tract suffers, therefore, the manifestations of this anemia are associated with disorders of the gastrointestinal tract. There is an appearance of hypersensitivity to acidic foods, glossitis, swallowing difficulties, atrophy of the gastric mucosa, an increase in the size of the liver and spleen.

In the blood system, the same changes occur as in B12 deficiency anemia. This is a transition to the megaloblastic type of hematopoiesis, the appearance of giant neutrophils, a decrease in the number of eosinophils, basophils and the total number of leukocytes.

Treatment of folate deficiency anemia To treat this type of anemia, folic acid tablets are used and the diet is normalized, in which there should be foods containing a sufficient amount of folic acid.

Hypoplastic anemia, causes, diagnosis, treatment Hypoplastic anemias are characterized by a decrease in the content of all cells in the blood ( pancytopenia). Pancytopenia is associated with the death of progenitor cells in the bone marrow.

Symptoms of hypoplastic anemia Hypoplastic anemia can be hereditary or acquired, but all subtypes of this type of anemia are characterized by the same manifestations. Consider these symptoms:

1. Bleeding, bleeding gums, fragility of blood vessels, bruising on the skin, etc. These phenomena occur due to the low content of platelets in the blood.
2. Ulcerative - necrotic lesions of the mouth, pharynx, nose, skin. Accession of infections. This is due to the low number of white blood cells in the blood.
3. Dizziness, headaches, tinnitus, drowsiness, fatigue, fainting, sleep disturbances, shortness of breath, heart palpitations, etc.
4. In the general blood test, a decrease in the content of all blood cells - erythrocytes, leukocytes, platelets. In the bone marrow, there is a picture of desolation, since the foci of hematopoiesis are replaced by adipose tissue.

Causes of the development of hypoplastic anemia What causes can cause such damage to the bone marrow? Hereditary anemia, respectively, is inherited, but acquired? All factors that can lead to the development of hypoplastic anemia are divided into exogenous (external) and endogenous (internal). The table shows the main exogenous and endogenous causes capable of causing hypoplastic anemia.

Principles of treatment of hypoplastic anemia Treatment of hypoplastic anemia is strictly within the competence of a hematologist. Various methods of stimulating hematopoiesis, or bone marrow transplantation, can be used.

So, we have considered all the main types of anemia. Of course, there are many more of them, but we cannot embrace the immensity. If any signs of anemia appear, you should consult a doctor in a timely manner. And regularly take a blood test for hemoglobin.

The deterioration that occurs due to lack of oxygen is known to many. The fact is that for normal life, all tissues of the body require nutrition. This refers to a sufficient amount of oxygen required by the cells. This is especially true of the tissues of the brain and heart. Insufficient supply of oxygen to the cells is observed in anemia. There are several varieties of this pathology. Some are due to congenital defects, others develop as a result of various disorders. Nevertheless, the main criterion for all anemia is an insufficient amount of hemoglobin in the blood. The manifestations of this pathology include pallor, changes in laboratory parameters and hypoxia of organs.

What is anemia?

Anemia is a disease of the hematopoietic system caused by a lack of hemoglobin. Normally, this protein should be maintained at a certain level (120-140 g / l in women, the indicator for men is 140-160). Hemoglobin deficiency can occur for various reasons. Regardless of why anemia occurs, it leads to a state of hypoxia. After all, hemoglobin is necessary for the transfer of oxygen to all organs and systems. Therefore, its deficiency leads to the fact that cells are deficient in O2. Each type of anemia has its own clinical picture and laboratory data. But an insufficient amount of hemoglobin in the blood is always diagnosed. Most often, anemia is suspected in the presence of symptoms such as pale skin and general weakness. This disease is quite common among pregnant women. A slight decrease in hemoglobin in most cases is not dangerous and is easily corrected with diet and medication. Severe anemia can lead to serious impairment. Therefore, it is necessary to provide emergency assistance with it.

Severity of anemia

There are 3 degrees of severity of anemia. They differ in the clinical picture and different levels of hemoglobin in the blood. Among them:

1. Anemia of mild severity. The content of hemoglobin at this stage is 120-90 g/l. Pathology is characterized by minor hemodynamic disorders. In some cases, it doesn't show up at all. Sometimes there is pallor, decreased blood pressure, increased heart rate, dizziness.
2. Anemia of moderate severity. At this stage, the amount of hemoglobin is 90-70 g/L. The symptoms are more pronounced. There may be fainting, memory and thinking disorders, drowsiness.
3. Anemia of severe severity is observed when the hemoglobin level is below 70 g/l. It is a dangerous condition for the body. It leads to a breakdown of all functional systems due to a pronounced lack of oxygen.

Varieties of severe anemia: classification

Severe anemia can develop against the background of any variety of this disease. Such a diagnosis is made regardless of the cause that caused the pathology. The main criterion is a pronounced hemoglobin deficiency - less than 70 g / l. However, it is important to distinguish one type of anemia from another. After all, the choice of methods of treatment depends on this. The classification of the disease is as follows:

1. Lack of hemoglobin caused by iron deficiency (IDA). This type disease is more common than others. It is caused by a violation of the absorption of iron or a small intake of this element with food.
2. B12 deficiency severe anemia. It is due to vitamin deficiency. Often found in people suffering from chronic gastritis.
3. Aplastic anemia of severe degree. It refers to congenital pathologies.
4. hemolytic anemia. This pathology is considered an autoimmune disease. It can be both congenital and acquired.
5. Severe Fanconi anemia. This disease refers to congenital defects of the hematopoietic system.

Severe anemia: causes of pathology

It is worth remembering that, regardless of the degree and variety, anemia never appears on its own, without a reason. To begin the treatment of pathology, it is necessary to find out what provoked the disease. Severe iron deficiency anemia is the most common. It occurs for the following reasons:

1. Insufficient supply necessary products. This refers to food rich in iron. Products containing this element are meat, liver, pomegranate, apples, etc.
2. Violation of iron absorption in the intestine. It develops due to enzyme deficiency or due to chronic diseases of the digestive tract.
3. Various types of blood loss. Therefore, it is so important to collect a gynecological history (duration and abundance of menstruation), to find out if there are hemorrhoids. As a result of these diseases, severe chronic anemia often develops. Acute blood loss can occur with a complication of peptic ulcer, cirrhosis of the liver, ectopic pregnancy, ovarian apoplexy and cyst rupture.
4. Severe injuries.

B12 deficiency anemia occurs with diseases of the stomach (chronic atrophic gastritis), resection of an organ in oncological pathologies, perforated ulcer.

Other causes of hemoglobin deficiency are congenital and autoimmune lesions of the red hematopoietic germ, hemolysis (destruction) of red blood cells.

The mechanism of development of severe anemia

Why does severe anemia develop? First of all, this happens if the patient does not notice the changes that occur with an unexpressed hemoglobin deficiency. Especially often this phenomenon can be observed in chronic blood loss. Since the human body gets used to constant "oxygen starvation", it is compensated by various mechanisms (increased cardiac activity). IDA develops due to iron deficiency. As a result, hemoglobin molecules are not formed in required quantity. In B12 deficiency anemia, vitamins are not absorbed in the gastrointestinal tract. This is due to inflammation or resection of the organ. Severe anemia is often found in congenital types of this disease. They develop as a result of immaturity with hematopoiesis. At the same time, a large amount of adipose tissue is found in the bone marrow.

Clinical picture in severe anemia

When the hemoglobin level falls below 70 g/l, a severe degree of the disease is diagnosed. In this case, the compensatory mechanisms of the body no longer work. For this reason, oxygen deficiency is felt in all functional systems. As a result, the following symptoms develop:

1. Severe pallor of the skin.
2. Violation of consciousness. In severe anemia, drowsiness and fainting may occur.
3. Drop in blood pressure.
4. Increased heart rate.
5. Dizziness.
6. Marked weakness. In this state, a person cannot get out of bed, when lifting his head, dizziness is observed, fainting is possible.
7. Dyspnea.

If you do not provide assistance in time, there may be a violation of the functioning of vital systems and organs. In such cases, acute renal failure, cardiogenic shock is often observed.

Anemia in pregnant women: features

Anemia is one of the symptoms that pregnant women often complain about. This is due to the fact that, in addition to the mother's body, oxygen is also needed by the child. Due to the appearance of an additional circle of blood circulation (placental), a decrease in hemoglobin is often observed. Therefore, the normal rate during pregnancy is 110 g / l. At plummet hemoglobin levels need urgent help. A severe degree of anemia in pregnant women is dangerous not only for the mother, but also for the child. Most often, it develops due to complications such as placental abruption or spontaneous miscarriage. Therefore, in case of bleeding from the genital tract, it is necessary to immediately call a doctor.

Diagnostic signs of anemia

In order to diagnose "anemia", it is enough to check the blood test. A severe degree of the disease is noted when the hemoglobin level is below 70 g / l. Clinical signs are pallor, decreased blood pressure, tachycardia, dizziness and fainting. Severe anemia is often accompanied by blood loss. To identify the cause of the decrease in hemoglobin levels, it is necessary to conduct a series of laboratory tests. For the diagnosis of IDA, do biochemical analysis blood. At the same time, such changes are observed as a decrease in the level of serum iron and an increase in TI. To diagnose other types of anemia, it is necessary to do a microscopic analysis of blood and cerebrospinal fluid. For this purpose, a lumbar puncture is performed.

What diseases differentiate severe anemia?

In some cases, anemic syndrome is observed in diseases of the hematopoietic system and liver. A decrease in hemoglobin accompanies almost all oncological pathologies. Especially it concerns cancer blood - leukemia. They can be distinguished from anemia by changes in other indicators in the KLA. These include: a decrease in the level of platelets and leukocytes, an acceleration of ESR. There are also differences in the clinical picture (subfebrile temperature, swollen lymph nodes). Anemic syndrome is present in cirrhosis of the liver, chronic hepatitis. To diagnose these pathologies, an ultrasound of the abdominal cavity, special laboratory tests are performed.

Severe anemia: treatment of the disease

Regardless of the cause of anemia, severe anemia requires a blood or packed red cell transfusion. In addition, symptomatic therapy is carried out. If the electrolyte balance is disturbed, physiological saline, preparations containing potassium are administered. If the cause of anemia is bleeding, emergency surgery is necessary. In addition, drug therapy is carried out. With a hemostatic purpose, sodium etamsylate, aminocaproic acid are administered. Aplastic anemia requires a bone marrow transplant. If the cause is a lack of vitamin B12, life-long replacement therapy is performed.

Sequelae of severe anemia

Be aware of the danger posed by severe anemia. Consequences given state- this is cardiogenic shock, acute renal failure, as well as dysfunction of other vital organs. These complications can lead to death. Therefore, even with minor bleeding, you should immediately consult a doctor.

Anemia (anemia) is a pathological condition of a weakened body, and the degree of anemia in hemoglobin shows the severity of the disease.

It is the reduced level of hemoglobin in relation to the norm that determines the diseases associated with anemia.

Along with this, a change in the total number of erythrocytes does not always characterize the clinical picture of this disease.

Anemia often acts as a consequence of other diseases. Such a pathology is associated with blood loss, impaired formation of red blood cells, destruction of red blood cells.

Understanding the causes and knowing the symptoms of anemia will help to recognize pathological processes in the early stages and prevent the disease.

Degrees of anemia, symptoms and manifestations

How much hemoglobin in the blood decreases determines the severity of anemia.

According to this parameter, the following levels of anemia are distinguished:

• mild ailments are manifested when the concentration of iron-containing protein exceeds 90 grams per liter of blood;
• the average stages of anemia are within the hemoglobin range of 70 to 90 grams/litre;
• the most severe anemias are characterized by a decrease in iron-containing protein to values ​​below 70 grams / liter.

Exist different kinds anemia, which basically have different causes.

Among them, the following variants of anemia can be distinguished:

1. posthemorrhagic associated with various blood loss;
2. hemolytic, caused by the destruction of red blood cells;
3. scarce, which appear due to a lack of body iron, vitamins;
4. hypoplastic, resulting from violations of hematopoietic processes inside the red bone marrow.

The most common anemia is caused by a lack of iron and vitamins in the body.

At this stage, with a normal specialized diet, a healthy lifestyle, hemoglobin can increase with a high degree of probability.

On the other hand, anemia can be caused by complex complex causes.

Whether such a disorder can normalize without complications depends on the setting. accurate diagnosis and a set of timely therapeutic measures.

Conditions of the body, similar in appearance to anemia, may occur due to thinning or thickening of the blood.

In the first case, with edema, excessive fluid in the tissue, hydremia is manifested. Thickening of the blood is detected with severe dehydration of the body, which may be the result of profuse diarrhea, loss of fluid through sweat, and vomiting.

At the same time, the level of hemoglobin and erythrocytes detected in the blood often remains within the normal range. Such manifestations characterize the diagnosis called "hidden anemia".

Most pathologies associated with anemia have common manifestations, which often affect a person’s well-being:

• decreased performance, general weakness, drowsiness, dizziness;
• shortness of breath at the slightest physical exertion, increased heart rate;
• headaches, tinnitus, "flies" before the eyes;
• loss of appetite up to its complete loss;
• impotence and menstrual cycle disorders;
• pale skin, mucous membranes;
• sleep disorders.

Except common features of this disease, specific, strictly individual manifestations of certain types of anemia can be detected.

Posthemorrhagic anemia

Weakness, lethargy, nausea, headaches, impaired coordination and loss of consciousness characterize the acute form of posthemorrhagic anemia, which is caused by large blood losses.

Sometimes anemia occurs due to bleeding disorders. In this case, there is a significant increase in leukocytes in the blood test.

Hemoglobin in posthemorrhagic anemia is reduced in both cases. Symptoms of this pathology are characteristic of common anemia.

Weakness, pallor, dizziness, fainting, nausea, headache, increased heart rate, palpitations may be detected.

Blood loss only aggravates such clinical conditions, and their critical level can even lead to death.

Therefore, they require immediate qualified medical care and hospitalization.

At the first stages of treatment, the lost blood volume is restored using intravenous drips. In parallel with plasma, blood are taken vitamin preparations and folic acid.

To uncover the underlying causes chronic form of this disease, it is necessary to conduct a thorough diagnosis. Treatment is aimed at increasing the level of hemoglobin.

With a mild degree of anemia, it is enough to provide a complete iron-containing diet, including meat products, especially beef liver, apples, pomegranate, buckwheat.

A severe degree of posthemorrhagic anemia requires specific treatment, which includes a balanced special diet, taking medications containing iron, vitamins.

Intensive optimal therapy, a healthy lifestyle and proper diet help solve the problems of anemia.

Hemolytic anemia

A common symptom that characterizes these diseases is jaundice. This is how bilirubin appears in the blood, an increase in the content of which occurs due to the breakdown of red blood cells.

The processes of destruction of red blood cells in this case significantly exceed their synthesis. Such anemia contains low hemoglobin precisely because of the lack of red blood cells.

Hemolytic pathologies often occur against the background of the development of certain infectious diseases.

With a weakened immune system, such blood diseases are the result of the spread of infections.

You can identify the disease through bloody inclusions in the urine, signs of jaundice, nausea, shortness of breath, weakness, dark urine and feces.

On the other hand, hemolytic anemias can be the result of alcohol poisoning, animal and plant toxins, and certain chemicals.

In the treatment of such abnormalities, regardless of severity, the factors that cause the disease should be initially eliminated.

Then focus on blood transfusion, a complete balanced diet with the use of iron-containing foods.

In addition, such diseases can be inherited. For example, hemolytic pathology of newborns appears due to a mismatch of the mother's erythrocytes according to the Rh factor to the antigens of the child's developing blood.

Of particular concern to hematologists is the negative indicators of Rh blood of the parents, especially the mother.

That is why during pregnancy such women undergo a constant blood test.

With such pathologies essential has the prevention of the disease through the control of the health of the pregnant mother.

Among hemolytic pathologies, some congenital diseases stand out.

Sickle cell anemia basically has a violation of hemoglobin synthesis, which leads to defects in its structure.

The iron-containing protein molecule stretches in length, disrupting the size of red blood cells and turning them into peculiar sickle-shaped formations with sharp tips.

When colliding with each other, blood cells destroy each other. In addition, the increased size of red blood cells often leads to blockage of small vessels.

Manifestations of this type of disease are decreased vision, swelling of the limbs, signs of jaundice, pain in the spleen.

Sickle cell anemia is treated with a transfusion of a mass of red blood cells or blood substitutes.

Thalassemia is characterized underproduction hemoglobin. This severe hereditary disease is not treatable.

Transfusion of blood substitutes helps to stabilize pathological conditions.

Deficiency anemia

Iron deficiency in the human body can occur due to various circumstances.

Chronic blood loss, an increased need for iron in a growing organism, pregnancy, impaired absorption of iron by the digestive system, and malnutrition are the main causes of such disorders.

With such anemia, the number of red blood cells and hemoglobin in the blood decreases, since 58% of the total iron in the body contains exactly hemoglobin.

This is accompanied by a change in taste sensations, smell. The skin becomes dry and pale, the hair thin and brittle.

Paleness, drowsiness, loss of strength, impaired coordination of movements, dizziness and tinnitus become constant companions of a person.

Therapeutic procedures for the treatment of anemia are aimed primarily at eliminating the causes of this pathology.

For example, iron deficiency anemia requires more iron, and anemia caused by vitamin B12 deficiency requires vitamins of this group.

Diagnosed anemia shows how to increase hemoglobin in each case.

At the same time, the introduction of a complete balanced diet is common for therapeutic procedures.

The diet should include beef liver, red meat products, fruits, vegetables, buckwheat, legumes.

It is better to limit the use of tea and coffee, giving preference to herbal decoctions, rosehip infusions, cocoa without milk.

In all cases, milk can be consumed in small portions separately from meals.

Medicines are prescribed most often in the form of tablets. In today's pharmacological market there is a huge selection iron-containing preparations and vitamins to treat anemia.

The daily dose of iron preparations for the prevention of anemia is 50-60 mg, with moderate anemia, it increases to 100-120 mg.

Severe degrees of anemia are treated in a hospital with injections under the close supervision of a physician.

With the positive dynamics of the disease, there is a gradual transition to tablets.

Anemia is a fairly common phenomenon, women are more prone to the appearance of the disease. This pathological condition is not an independent disease, it is a consequence of a disorder in the body. A decrease in the level of hemoglobin in erythrocyte cells has various causes, severity and types of pathology. Anemia 1 degree - what is it? This is what doctors say mild degree pathological condition which is usually treated successfully.

Causes of anemia

A disease in which there is a decrease in hemoglobin in the blood is known in medicine as anemia. What is anemia? This popular term has nothing to do with total blood in the human body. The main role in the development of pathology is played by the iron-containing protein hemoglobin, or rather its quantity. With a significant decrease in the amount of protein, we can talk about the occurrence of anemia.

There are many reasons why pathology develops:

• Congenital or acquired dysfunction of the body to the formation of red blood cells. Sometimes as a result of illness or hereditary factor red blood cells become deformed (bulging, large, small, etc.) or the body simply does not produce enough of them. As a result, anemia develops.
• Violation of the enzymatic composition of erythrocytes can be a congenital pathology.
• A complete healthy diet plays an important role not only for a slim figure, but also for the hematopoiesis process. Lack of vitamin C, B12, folic acid or iron provokes the development of anemia. Starvation and insufficient intake of nutrients (veganism, strict diets, etc.) are a direct path to anemia.
• Sometimes a malfunction in the body is due to physical injuries, burns or frostbite. The stress that an injury gives changes the chemical composition of the blood and anemia is possible. The physical ailment should be treated first.
• Poisons and some types of antibiotics can significantly inhibit the functions of the body.
• The composition of the blood can seriously change under the influence of radiation. Also, anemia is often diagnosed in patients undergoing radio and chemotherapy.
• Serious infectious, inflammatory and chronic diseases lead to the development of anemia. Also, malignant neoplasms inhibit hematopoietic function.

Anemia 1 degree - what is it? The initial or early form of the pathological condition. Most often, this type of pathological condition is determined by a blood test as a result of a routine medical examination. Signs of deficiency of iron-containing protein are not expressed and are written off by a person for ordinary fatigue.

Disease types

There are various classifications of anemia. For treatment, it is important not to lay down the diagnosis, but also to find out the cause of the pathology. Depending on this, appropriate therapy is prescribed. First of all, nutrition is corrected. Depending on the severity of the disease, appropriate medications are prescribed.

Iron deficiency anemia, as the name implies, is associated with a lack of iron. Anemia 1 degree is characterized by a slight decrease in iron in the blood. The consequences of the disease will not be long in coming, they appear from the beginning of the development of the pathology and only get worse in the future.

This type of pathology is caused by malnutrition(lack of animal proteins in the diet), impaired absorption of iron, increased need for an element (pregnancy, etc.) or significant loss of iron (bleeding).

A lack of vitamin B-12 leads to B-12 deficiency anemia. This occurs as a result of insufficient B-12 content in food, the course of a serious disease (cancer, cirrhosis of the liver, etc.), multiple pregnancy. Severe anemia due to vitamin B-12 deficiency is treated with intramuscular injections and special nutrition.

When the hemoglobin in the blood decreases as a result of a decrease in the concentration of folic acid, doctors diagnose folic acid deficiency anemia. The reason for this may be insufficient intake of the substance with food, malabsorption or loss of folic acid due to illness. The sick person feels weak and tired, skin covering becomes pale.

Aplastic anemia is associated with a defect in the development of the bone marrow, which may be congenital or acquired. As a result, suffering common function formation of blood cells, both erythrocytes and others.

This may be due to damage to the body by HIV, autoimmune and other diseases, as well as the action of certain drugs.

Hemolytic anemia occurs due to the premature destruction of red blood cells. Red blood cells do not die before the bone marrow has time to produce new ones. The cause may be defects in the structure and synthesis of cells. Tachycardia, abdominal pain, and yellowness of the skin are added to typical symptoms.

Severity of anemia

According to the severity of anemia are divided into 3 types. The stages of anemia differ in the concentration of iron-containing protein in red blood cells, which reflects the blood test. According to the level of iron-containing protein, the patient's health status is assessed. Normal hemoglobin is 120–140 g/l. in women and 130-160 g / l. in men. When anemia occurs, the normal rate begins to decline.

• Anemia of the 1st degree is the initial stage of the pathological state of the blood. The consequences of this form of pathology are not expressed, the symptoms may be mild. However, it should be noted that in the absence of qualified assistance health condition will worsen and symptoms will intensify. The indicator of iron-containing protein does not fall below 90 g / l. At this stage, a person may feel fatigue, weakness, slight ailments, and a decrease in appetite. Children become moody and whiny, adults tend to keep their emotions under control.
• Anemia of the 2nd degree is a more serious condition. Anemia of moderate severity is a kind of transitional period between minor violations and the development of a severe form of pathology. During the second stage of the pathology, discomfort intensifies. In this case, the person can no longer ignore the signs of anemia and, as a rule, go to the doctor. With anemia of moderate severity, hemoglobin is contained in the range of 90-70 g / l. A person has headaches, dizziness, impotence. This is due to the fact that the cells of the body receive less oxygen, which is carried throughout the body by red blood cells. The skin becomes dry, pale or slightly icteric. There may be complaints of tachycardia, disorders of the gastrointestinal tract.
• Anemia of the 3rd degree is the most severe form of the disease, which is subject to immediate and thorough treatment. The absence of any treatment threatens with serious consequences for the health of the patient. The most severe condition can lead to the death of the patient. Hemoglobin falls below 70 g/l. Nails and hair change structure and become brittle, hands and feet get cold and often go numb. The liver and spleen increase in size.

Forecast

Severe anemia has negative consequences for the body, in some cases even death. Treatment of the third stage of the disease usually requires hospitalization, while mild form diseases are quickly cured at home. Anemia is dangerous, primarily because red blood cells cannot fully provide the cells and tissues of the body with oxygen and nutrients.

At first, violations may not be noticeable, but they occur from the first stage and intensify over time:

• As a result of an anemic disease, a person constantly feels tired and depressed. Over time, irritability and neurological disorders appear.
• Immunity is significantly reduced, the number of leukocytes decreases. The person becomes susceptible to infections and often gets sick.
• The pathological process progresses to cellular level. In the initial stage, it affects the skin, then spreads to epithelial cells. internal organs. Possible violations in the work of the heart, digestive system, etc.
• An increase in the liver and swelling of the extremities as a result of a deficiency of iron-containing protein in anemia gives an additional burden to the body.

Treatment

Different degrees of anemia suggest completely different treatments. Mild anemia can be successfully cured by taking a complex of vitamins and a special, nutritious diet. It all depends on the result of the blood test, if the decrease in hemoglobin is insignificant, then the treatment will be quite simple, but effective. To establish the diagnosis, a blood test is performed first.

This type of study determines the quantitative and qualitative index of red blood cells and measures the hemoglobin in them.

With anemia of 1 degree, the diet changes first of all. Any diets, vegetarianism and other restrictions are excluded at least for the duration of treatment. You should eat enough of the foods recommended by your doctor. In addition, the intake of missing substances is prescribed. The drugs are very effective, for example, iron tablets are absorbed by the body 15-20 times better than iron from food.

Severe anemia is treated under the supervision of a doctor in the hospital. This condition is fraught with danger to the life of the patient. Missing vitamins and substances are taken in the form of tablets or injections are prescribed. In some cases, a red blood cell transfusion may be performed. This is an effective way to quickly increase the number of healthy red blood cells with a normal protein content in the patient's body.

Features of nutrition and prevention

For people who receive insufficient amounts of vitamins and nutrients, doctors recommend increasing the intake of missing substances by two or more times. Typically, the list of products recommended by a doctor includes the following products:

• Meat and meat sausages should definitely be included in the diet, especially for children. As a healthy diet, meat can be stewed, baked or boiled, homemade sausages can be prepared from lean meat. The liver is especially useful
• Fish should be eaten at least twice a week.
• Bread is best baked with whole grain flour.
• From plant foods, germinated wheat germ, spinach, parsley, fennel, beets, Brussels sprouts are recommended.
• Useful nuts, pumpkin seeds, sesame seeds, etc.
• In summer, the diet should include blackcurrants, apricots, and other seasonal berries and fruits.

You should carefully listen to the body and not ignore fatigue and depression. According to the characteristic signs, one can suspect the development of anemia, start treatment on time and not bring the pathology to a severe form. With frequent ailments and constant fatigue you should immediately consult a doctor and take the necessary tests.

The division of anemia according to severity makes it possible to classify the disease, define the state of health and prescribe the appropriate treatment. There are a large number of types of this pathology and it is very important to conduct a high-quality diagnosis. However, in most cases, a person simply needs to eat well and keep their body in shape to stay healthy.

In contact with

Anemia (anemia) is a decrease in hemoglobin in the blood. The most common anemia is due to iron deficiency, less often - vitamin B12 and folic acid. It is considered not as an independent disease, but as a complication of another disease, acute or chronic. People of all ages are susceptible to anemia, mostly women, it is especially dangerous for pregnant women and young children.

It is important to note that a decrease in the level of hemoglobin may not have clinical manifestations, that is, it may not be noticeable in terms of physical well-being.

Anemia is a lack of red blood cells

Severity

Depending on the concentration of hemoglobin, according to the severity of anemia, they are divided into:

1. mild anemia(with the amount of hemoglobin - 100-120 grams per 1 liter of blood (g / l) for men, 90 -110 g / l for women);
2. anemia of moderate severity(with the amount of hemoglobin - 80-100 g / l for men, 70-90 g / l for women);
3. severe anemia(hemoglobin level below the above limits).

Causes of anemia

The reasons for the development of anemia are different - it can be bleeding, including internal (intestinal, uterine, pulmonary), occurring as a result of various diseases. Anemia may develop as a result of taking certain medications, and as a result wrong image life - excessive passion diets, work in hazardous industries, as well as a complication of certain diseases.

As a result of all these adverse factors, iron deficiency occurs, in which the bone marrow produces red blood cells that are deprived of hemoglobin. Iron deficiency anemia is especially common among women of childbearing age or who are pregnant.

With a lack of vitamin B12 in the body, precision anemia develops, to which the tissues of the nervous system are especially sensitive. It affects mainly the elderly, which is associated with atrophy of the stomach. Anemia also occurs due to the destruction of red blood cells, which occurs as a result of some serious diseases.

Iron deficiency anemia often develops during pregnancy because iron during this period is required twice as much as in the normal state. Anemia during pregnancy is dangerous, because the fetus, which needs iron for the formation of blood cells, suffers first of all.

If the mother has anemia - the fetus does not receive the oxygen it needs for normal development, various infections may develop after childbirth. And finally, a pregnant woman suffering from anemia feels worse, there is a risk premature birth, which will be accompanied by excessive bleeding, dangerous for the mother and child, since blood clotting decreases with anemia. Anemia in pregnant women must be treated and prevented.

Symptoms

Often, mild anemia occurs without pronounced symptoms and is detected only during examination. Common symptoms of more severe anemia are fatigue, malaise, dizziness and headaches for no apparent reason, shortness of breath with little exertion or at rest. It is also possible the development of heart failure, palpitations, fainting, pallor or cyanosis of the skin, especially on the limbs, and nails. If such signs occur, you should consult a doctor for examination - anemia is diagnosed by a general clinical blood test.

Diagnostics

Diagnosis of anemia is based on blood tests. This is a general blood test that shows blood levels of hemoglobin, red blood cell count, hematocrit, ESR, white blood cell count and composition. If a decrease in hemoglobin level is detected in the blood, a number of additional tests are necessary to establish the exact type of anemia.

They can also be carried out additional research and analyzes to determine exact reasons the development of the disease. It can be gastroscopy, colonoscopy, computed tomography and many other studies, depending on each individual case.

Treatment

Therapy is aimed primarily at eliminating the cause that caused it. Treatment of anemia is carried out both in the hospital and on an outpatient basis. Having determined the cause that caused anemia, the doctor will prescribe drugs that make up for the lack of substances: iron preparations, vitamins B12, folic acid. For more severe anemia, a blood transfusion may be needed to restore blood volume. In some cases, it is necessary to cancel drugs that suppress hematopoiesis.

An important condition for the treatment of anemia is a healthy lifestyle - proper balanced nutrition, alternation of stress and rest. It is also necessary to avoid contact with chemical or poisonous substances and oil products.

Prevention

As an anemia prevention, it is first of all necessary to lead a healthy lifestyle and have a balanced diet. It is necessary to eat foods high in iron: legumes, meat, nuts, dried fruits. If the cause of anemia is a lack of vitamin B-12, then it must be replenished by eating meat and dairy products, and if the cause is a lack of folic acid, orange and other fruit juices.

Additionally, you can use multivitamin complexes containing folic acid and iron. But just remember that such complexes should be prescribed by your doctor in order to avoid getting negative effects from an overdose. Don't let uncontrolled reception similar drugs.

Sincerely,

Anemia (anemia) is a very common and serious disease that occurs when the most various bodies and systems and has very different clinical significance. The pathogenetic classification of anemia given below, according to which the description of various forms of anemic conditions is located further, indicates simpler mechanisms of their occurrence, which are easier to clarify in the clinic. Involvement violation nervous regulation is of great importance in the origin of each of the given pathogenetic groups of anemia and should be taken into account in the clinic with special care.

1. Acute anemia from blood loss- "anemia" in the narrow sense of the word: in the first hours after blood loss, a smaller amount of qualitatively unchanged blood circulates in the vessels, which leads primarily to acute vascular insufficiency and sometimes even to death. By the end of the first half-day, the normal mass of blood is restored due to the absorption of tissue fluid and there are signs of a lack of hemoglobin and iron.
2. Deficiency in the body of iron due to malabsorption of iron contained in food, or its low content in food, as well as as a result of repeated blood loss, leads to anemia, in which red blood cells, even with a sufficient number of them, are poor in pigment (hemoglobin), hypochromic chloranemia, united by the main factor by the term iron deficiency anemia.
3. In another group of anemias, erythrocyte maturation suffers due to lack of an antianemic agent, formed from food under the influence of the hematopoietic enzyme Castle in the stomach and deposited in the liver; at the same time, immature erythrocytes of a large size, well stained with hemoglobin, are formed - hyperchromic, megalo- and macrocytic anemia.
4. Regardless of the sufficient amount of hematopoietic substances and the good functioning of the bone marrow, anemias arise from the increased breakdown of red blood cells in certain metabolic disorders, poisonings and infections. hemolytic anemia.
5. Regardless of the presence of hematopoietic substances in the body, anemia occurs when the bone marrow is destroyed, it is displaced, for example, by a tumor, or by bone growths, with paralysis, inhibition of its function - and plastic and hypoplastic anemia.

Some rare pathogenetically and etiologically insufficiently clear forms of anemia do not fit into these groups.

Numerous other previously proposed classifications of anemia are clinically less substantiated. Thus, primary anemias are often distinguished - in diseases of the blood system itself - and secondary, or symptomatic anemias - in diseases of the stomach, kidneys, infections, etc. However, the development of classic primary anemias - malignant anemia and chlorosis - is currently associated mainly with damage to other systems - a violation of the gastrointestinal digestion and absorption, and nervous regulation. True, in each anemic or, more broadly, hematological syndrome, it is important to isolate symptomatic forms, to establish the main cause of the disease in this case, especially if this cause can be eliminated. Similarly, both hemolytic and aplastic anemias, which are often not associated in the clinic with damage to any organ, arise as a result of intoxication, metabolic disorders and hyperergic reactions, which in turn arise as a result of impaired nervous regulation. Botkin attached primary importance to the neurogenic factor in the origin of anemia, distinguishing anemia from damage to the centers of the brain and peripheral neuroreflex forms. However, the neurogenic factor has not been studied to such an extent that it can already be put at the present time as the basis for the practical classification of anemia.

The division of anemia into hemolytic and hyporegenerative is of great importance, but, for example, hemolysis may be based on defects in the structure of erythrocytes (their undermaturation during malignant anemia) or at the same time an increased function of the cellular hemolytic system (as in chronic hemolytic anemia), or, finally, the presence of hemolysins in the blood, which is why, from a practical point of view, it is impractical to combine, for example, all anomies with increased blood breakdown into one pathogenetic group.

Morphological or narrowly hematological divisions of anemia according to the characteristics of erythrocytes into hyperchromic and hypochromic, megalo-, macro- and microcytic, megaloblastic and normoblastic ones are essentially close to distinguishing two main forms arising from the insufficiency of the main hematopoietic substances - antianemic substances and iron. But morphological features, for example, in relation to the color indicator, are not so conclusive, since the color indicator above one can also be with a lack of an antianemic substance. And with hemolytic anemia; also, microcytosis can develop not only as a result of iron deficiency, but also as a result of increased hemolysis, therefore these rubrics do not give the clinician direct indications of the necessary pathogenetic therapy. Morphological signs of peripheral blood do not always correspond to the state of the bone marrow and therefore may be of less fundamental importance, while the study of bone marrow punctate does not always give unambiguous results and is somewhat difficult to everyday use. Establishment in various hematological syndromes etiological factors widely used for practical purposes of prevention and treatment.

Anemia (anemia) - a decrease in the total level of hemoglobin (Hb), more often manifested in a decrease in it per unit volume of blood. True anemia differs from pseudoanemia in the hematocrit value (in adults it is 36-48%).

About 30% of the world's population is anemic, and half of them, 600 million people, are iron deficient. Separation of anemias by size of red blood cells (MCV) indicates probable cause. Red blood cells in the bone marrow must accumulate a minimum level of hemoglobin. Erythrocyte precursors undergo division, which is regulated by erythropoietin. If the erythrocytes are not supplied with the required amount of hemoglobin, more than normal cell divisions will occur before entering the blood, and the volume of the erythrocyte will be reduced. MCV may become smaller due to the lack of components needed for the hemoglobin molecule. With iron deficiency, there is not enough iron; with thalassemia - globin chains; with congenital sideroblastic anemia - heme rings; and sometimes lack of iron utilization leads to anemia of chronic disease. In megaloblastic anemia, biochemical disorders caused by a deficiency of vitamin B 12 or folate inhibit the synthesis of new bases for building DNA. A similar defect in cell division in the bone marrow is observed under the influence of cytostatics and in some hematological diseases, such as myelodysplasia. In this case, the cells receive enough hemoglobin, but pass through a smaller number of divisions, as a result, circulating red blood cells increase the MCV. The erythrocyte membrane is built as a double lipid layer, which is easily exchanged with plasma plasma lipids. Liver disease, hypothyroidism, hyperlipidemia and pregnancy accompanied by an increase in plasma lipids can cause an increase in MCV.

The term "anemia" refers to a decrease in the number of red blood cells, hemoglobin (the main indicator for anemia) and / or hematocrit in a normal, as a rule, total blood volume. Immediately after acute massive blood loss, with dehydration or hyperhydration, the diagnosis of anemia can only be made after the restoration of the BCC. The pathogenetic classification of anemia reflects the violation of individual stages of erythropoiesis, as well as the lifespan of erythrocytes circulating in the blood (hemolytic anemia).

Erythropoiesis disorders occur when:

1. violation or lack of differentiation of pluripotent hematopoietic stem cells (aplastic anemia in panmyelopathy or acute myeloblastoma leukemia);
2. transient (with viral infections) or permanent decrease in only erythropoiesis precursor cells (isolated aplastic anemia) due to the formation of autoantibodies against erythropoietin or membrane proteins of erythropoiesis precursor cells;
3. erythropoietin deficiency in kidney pathology (the so-called renal anemia);
4. chronic inflammation or tumors that activate, among other things, interleukins that suppress erythropoiesis (secondary anemia);
5. violations of cell differentiation (ineffective erythropoiesis), the cause of which, in addition to genetic defects, may be a deficiency of folate or vitamin B 12 (megaloblastic anemia);
6. disorders of hemoglobin synthesis (microcytic hypochromic anemia).

Acute posthemorrhagic anemia

Causes of acute posthemorrhagic anemia

The occurrence of the disease contribute to:

• all kinds of injuries, especially with damage to large vessels;
• ectopic pregnancy;
• various diseases of the internal organs, accompanied by acute bleeding (gastric ulcer and DNA, varicose veins of the esophagus with cirrhosis of the liver, a decaying tumor of the stomach; tuberculosis, lung abscess and bronchiectasis);
• hemorrhagic diathesis, especially hemophilia.

A condition associated with the rapid loss of a significant volume of blood (20-25% of blood over about 1 hour). The factor that determines the degree of dysfunction and compensation is uncorrected hypovolemia.

Stages of compensation for acute blood loss

Reflex phase of compensation. Occurs on the 1st day after acute blood loss due to the activation of the sympathoadrenal system: peripheral vascular resistance increases, redistribution of blood occurs (circulation centralization).

Hydramic phase of compensation. It occurs on the 2-4th day and consists in moving fluid from the extracellular space into the vessels. One of the mechanisms of the hydraemic phase is catecholamine-induced hyperglycemia due to glycogenolysis in the liver; the content of basic electrolytes in plasma remains practically unchanged.

Bone marrow phase of compensation. In this phase, the activation of the formation of erythropoietins in the kidneys against the background of severe hypoxia is important.

In the first time after blood loss, due to a decrease in the volume of the vascular bed, a decrease in the content of hemoglobin and erythrocytes is usually not detected, the hematocrit also does not change.

In connection with hydremia, a gradual drop in the levels of hemoglobin and erythrocytes begins.

Treatment of acute posthemorrhagic anemia

Aimed at the rapid restoration of circulating blood volume: blood transfusion, the introduction of colloidal or saline solutions. For hemostasis, calcium chloride, vikasol, sewn-in plasma, fibrinogen, aminocaproic acid are administered intravenously. If necessary, surgical control of bleeding is performed.

Chronic posthemorrhagic anemia

Anemia that develops as a result of repeated loss of small volumes of blood during bleeding from the gastrointestinal tract, with renal, uterine, nasal and hemorrhoidal bleeding.

Peripheral blood is characterized by a decrease color indicator, microcytosis, moderate leukocytosis with a neutrophilic shift to the left. At long course disease, anemia acquires a hyporegenerative character.

Anemia associated with impaired blood formation

1. Dysregulatory- due to a violation of the regulation of hematopoiesis with a decrease in the production of erythropoietins or an increase in the number of their inhibitors (chronic kidney disease, hypofunction of the pituitary gland, adrenal glands, thyroid gland).

2. Scarce- occurs when there is a lack of substances necessary for erythropoiesis (iron, vitamins, protein).

Iron-deficiency anemia accounts for up to 80% of all anemias and develops as a result of an imbalance between the intake of iron in the body, its use and losses.
Losses of iron are observed with repeated and prolonged bleeding - uterine, gastrointestinal, renal, pulmonary, with hemorrhagic diathesis.

In some cases, alimentary iron deficiency (less than 2 mg per day) is possible, for example, with a small amount of meat food intake, with artificial feeding, or with late feeding in childhood.

Reduced absorption of iron is observed with hypoacid gastritis, chronic enteritis, or with resection of the gastrointestinal tract.

Violation of iron transport is possible with hereditary or acquired hypotransferrinemia.

Increased iron consumption develops during periods of growth and maturation, during pregnancy and lactation, and in chronic inflammatory diseases.

Iron deficiency is accompanied by an increase in ineffective erythropoiesis, a decrease in the life span of erythrocytes.

The blood picture is characterized by a decrease in hemoglobin content (from 100 to 20 g / l), the content of red blood cells can be normal or significantly reduced, hypochromia is detected. The tendency to microcytosis, poikilocytosis, regenerative or hyporegenerative nature of anemia are also typical.

In the peripheral blood, there are: the level of serum iron is below 30 µg/l; the content of ferritin in the blood is below 40 mcg / l.

Serum iron deficiency is manifested by increased fatigue, perversion of taste and smell, general weakness, headaches. Iron deficiency also leads to a decrease in the level of myoglobin and the activity of tissue respiration enzymes. The consequence of hypoxia is dystrophic processes in organs and tissues. Frequent layering and brittleness of nails, stomatitis, caries, atrophic gastritis, etc.

Anemia due to vitamin B 12 deficiency (pernicious)

Deficiency of vitamin B 12 can develop due to a violation of its intake, absorption, transport, storage and assimilation at the level of the bone marrow.

Malabsorption is likely in the absence internal factor Castla (transcorrin), with atrophic processes on the part of the gastric mucosa, with a hereditary selective disorder of vitamin production, with autoimmune destruction, with an agastric form of deficiency.

The absorption of vitamin B|2 is sharply limited in case of widespread damage to the small intestine - with enteritis, celiac disease, and also during its resection.

The pathogenetic role of the competitive consumption of the vitamin during invasion with a wide tapeworm, as well as in the syndrome of the "caecum" (when anastomoses are applied, sections of the small intestine remain) are shown.

In some cases, a lack of transcobalamin leads to vitamin B 12 deficiency.

Deficiency of vitamin B 12 causes a violation of DNA formation and further a disorder in the division of hematopoietic cells, i.e. slowing down the mitotic process and reducing the number of mitoses. Under such conditions, a megaloblastic type of hematopoiesis similar to the embryonic type is formed.

The development of anemia is associated with the following mechanisms.

1. Decreased mitotic activity.
2. Ineffective erythropoiesis due to intramedullary destruction of megaloblasts.
3. Extravascular hemolysis in the spleen due to enlarged megalocytes.
4. Intravascular hemolysis due to a decrease in the osmotic resistance of the megalocyte membrane.

Peripheral blood reveals severe anemia, predominantly hyperchromic, hyporegenerative. The presence of nuclear remnants, anisocytosis, poikilocytosis are typical. Neutropenia and thrombocytopenia are also noted.

Folate deficiency anemia in terms of the mechanism of development and blood picture is close to vitamin B 12 deficiency.

Hypo- and aplastic anemias

These anemias are a set of syndromes in which, along with pancytopenia, oppression of hematopoiesis in the bone marrow is detected.

According to the etiology, aplastic anemia is divided as follows:

1. Genuine (idiopathic), constitutional and hereditary, caused by a violation of the reactivity of the body or endocrine insufficiency.
2. Aplastic anemia associated with the action of damaging factors: radiation, toxic factors (benzene, mercury), cytotoxic (chlorethylamine, ThioTEF, colchicine, 6-mercaptopurine, etc.), drugs (amidopyrine, barbiturates, sulfonamides, chlorpromazine), infectious (viral hepatitis A, B, generalized forms of tuberculosis, typhoid fever, salmonellosis, septic conditions).

In pathogenesis, the following mechanisms are important:

1. Reducing the number of stem cells or their defects.
2. Violation of the microenvironment, leading to a change in stem cells.
3. Immune influences causing disorders of stem cell function. The blood picture is characterized by a pronounced, often normochromic, macrocytic, hyporegenerative anemia. Significant granulocytopenia and thrombocytopenia are noted. The number of myelokaryocytes in the bone marrow decreases. Clinical picture depends on the degree of violation of individual germs of hematopoiesis and their combinations; it includes anemic, thrombocytopenic and granulocytopenic syndromes.

Hemolytic anemia

This group includes various anemias associated either with hereditary increased destruction of erythrocytes, or with the action of hemolytic factors of exogenous origin.

Hereditary hemolytic anemias

1. Anemia associated with a violation of the erythrocyte membrane (membranopathy). hereditary microspherocytosis- autosomal dominant type of inheritance, characterized by an increase in the permeability of the erythrocyte membrane and excessive intake of sodium ions into the cell. There is swelling of erythrocytes, a violation of the ability to deform and a decrease in their life expectancy, destruction of the spleen by macrophages.

With microspherocytosis, the absence or violation of the binding of the spectrin membrane protein to protein 4.1 was revealed. It is assumed that the formation of the tetrameric form of spectrin from the dimeric form is disrupted, as well as the absence of erythrocyte membrane proteins, designated 4.2.

Usually anemia is normochromic, regenerative. According to the blood picture, it differs in varying degrees of severity, during a hemolytic crisis it is sharper, but at the same time high reticulocytosis develops.

Membranopathies also include elliptocytosis (ovalocytosis), stomatocytosis (mouth-shaped erythrocytes).

Acanthocytosis is caused by a violation of the lipid structure of the erythrocyte membrane.

2. Anemia associated with impaired activity of erythrocyte enzymes. Deficiency of enzymes involved in energy production in erythrocytes leads to a violation of the ionic composition, a decrease in resistance to oxidizing agents and a decrease in the lifespan of these cells.

A hereditary deficiency of the enzymes of lycolysis and ATP metabolism (hexokinase, hexophosphate isomerase, phosphofructokinase, pyruvate kinase, ATPase) has been described.

Deficiency of enzymes of the pentose phosphate cycle leads to a lack of NADP * H2, which is necessary for the reduction of glutathione, a factor that resists the action of oxidizing agents. This happens with a deficiency of glutathione synthesis enzymes - glutathione synthetase, glutathione reductase, glutathione peroxidase.

In such cases, anemia of varying severity is formed. Usually normochromic, with anisocytosis, poikilocytosis, polychromasia. The content of reticulocytes is increased, especially during exacerbations.

3. Anemia associated with a violation of the structure and synthesis of hemoglobin (hemoglobinopathies).

Immune hemolytic anemias

Heterogeneous group of diseases, united by the participation of antibodies or immune lymphocytes in the damage and death of erythrocytes or erythrokaryocytes.

Iso- or alloimmune anemia can develop with hemolytic disease of the newborn or with blood transfusion.

Heteroimmune anemia (haptenic) associated with the appearance of new antigens on the surface of erythrocytes (for example, as a result of fixation of drugs on erythrocytes - penicillin, sulfonamides). Sometimes a virus, also fixed on the surface of an erythrocyte, becomes a hapten.

Autoimmune hemolytic anemias- a group of diseases caused by the formation of antibodies against the own antigens of erythrocytes or erythrokaryocytes.
In addition to idiopathic, there are also symptomatic autoimmune anemia; in them, hemolysis develops against the background of other diseases ( malignant tumors various localization and hemoblastosis, systemic lupus erythematosus, rheumatoid arthritis, immunodeficiency states).

The most likely pathogenetic basis of autoimmune hemolytic anemia is the breakdown of immunological tolerance.

In the blood picture, mild anemia is noted, more often normochromic, with high content reticulocytes. In hemolytic crises, blood counts are disturbed to a greater extent, reticulocyte crises are possible with an increase in the content of reticulocytes up to 80-90%.

B 12 deficiency (pernicious) anemia

Symptoms and signs. At 12 - deficiency anemia develops slowly, gradually. Increasing weakness, fatigue, shortness of breath are noted.

In the hemogram - a decrease in the number of erythrocytes with a high saturation of their hemoglobin, MSI > 31 pg. Red blood cells of unequal size (anisocytosis), macrocytes predominate.

Diagnostics. The diagnosis is made in the presence of hyperchromic anemia with macrocytosis, leukopenia and thrombocytopenia, MSI > 31 pg, autoimmune gastritis with achlorhydria, signs of damage to the nervous system. It is confirmed by the hematological effect of treatment with vitamin B 12 .

Treatment. Held subcutaneous injection vitamin B 12.

folate deficiency anemia

Folate deficiency anemia is much less common than B 12 deficiency, since folates are found in meat (meat, liver) and plant products.

Causes. Lead to the development of the disease: extensive resection of the small intestine; celiac disease; prolonged starvation (GULAG); taking anticonvulsants (difenin, phenobarbital, etc.), anti-tuberculosis and contraceptives; alcoholism (increases the need for folic acid); hemolytic anemia (the need for folic acid is increased due to constant proliferation processes in the bone marrow); pregnancy; culinary processing of food (when boiling after 15 minutes, folic acid is completely destroyed).

Symptoms and signs. The anemic syndrome is similar to that of B12 deficiency anemia. The difference is in the presence of complaints of dysfunction of the gastrointestinal tract; there is no funicular myelosis, but epilepsy, schizophrenia, and mental disorders are common.

In the blood - signs of hyperchromic anemia, pronounced anisocytosis, a decrease in the number of erythrocytes, platelets and leukocytes. The bone marrow contains megaloblasts.

Treatment. Carried out with folic acid; prophylactic folic acid intake, if the cause of its deficiency is not eliminated.

Prevention. It is carried out in pregnant women and patients with hemolytic anemia - a constant intake of folic acid (1 mg / day).

Anemia due to impaired hemoglobin synthesis

Erythrocytes are necessary for the transport of O 2 and CO 2, as well as for maintaining the buffering properties of the blood. Hemoglobin is important for all three of these functions. Its molecule consists of four subunits, each of which includes three components: protoporphyrin, iron (Fe 2+) and globin (α or β). When Fe 2+ is included in the structure of protoporphyrin, heme is formed. Hemoglobin synthesis is impaired when one of the heme components is deficient or defective. In these cases, the size of erythrocytes usually decreases (MCV), the hemoglobin content in them also decreases (MSN) (microcytic hypochromic anemia).

Disorders in the synthesis of protoporphyrins occur as a result of a hereditary deficiency of enzymes, for example, with hereditary sideroblastic anemia, in which the formation of δ-aminolevulinic acid (δ-ALA) from glycine and succinyl-CoA, and hence the synthesis of heme, is impaired. Heme inhibits δ-ALA synthase activity in a negative feedback manner. In other words, if the heme concentration decreases, the inhibition of the enzyme stops and, despite the defect, a sufficient amount of heme is formed. Defects in enzymes that catalyze subsequent metabolic transformations lead to an increase in the concentration of intermediate products. Due to the increase in the rate of heme formation, these metabolites cause other disorders - porphyrias.

Globin synthesis disorders. Before birth, the child has a type of hemoglobin that has an increased affinity for O 2 , which is a mechanism for adaptation to low PO 2 in the blood vessels of the placenta. This fetal hemoglobin (HbF) contains y-chains instead of β-chains.

The properties of hemoglobin (solubility, affinity for O 2 , oxidizability, etc.) depend on the sequence of amino acids in the protein part of the molecule. At the same time, not all of the more than 300 known genetically mediated hemoglobin variants are characterized by a violation of the functional properties of hemoglobin. On the other hand, even a single “abnormal” amino acid (substitution of glutamine for valine at the 6th position of the β-chain to form HbS) can lead to serious functional disorders observed in sickle cell anemia caused by a homozygous gene defect. In the oxidized state, HbS clusters so that the erythrocytes become sickle-shaped. Ethyl cells are able to deform, they form aggregates, clogging small blood vessels. Aggregation of erythrocytes occurs within a few minutes, so it is more pronounced in capillaries with slow blood flow (spleen, direct vessels of the renal medulla). With a general slowdown in blood flow (shock) or hypoxia (in high altitude conditions, during air travel, during anesthesia), erythrocyte aggregation may increase in other organs (for example, in the heart). Occlusion of blood vessels impairs blood flow in the affected organs and tissues and PO 2 decreases further, leading to vicious circle. Sickle cell anemia occurs almost exclusively in blacks who either themselves or their ancestors migrated from regions of central Africa with a high prevalence of malaria. The “survival” of the defective gene in 40% of the population of Central Africa, despite the fact that until recently children homozygous for the given gene died, can be explained by the fact that heterozygous gene carriers are protected from severe forms malaria (selective advantage).

In β-thalassemia, the formation of β-chains is reduced, which leads to a lack of HLA. This can be partly compensated by increased production of HbA 2 and HbF. Partially included in the composition of the heme, therefore, in erythrocytes, part of the iron remains unused (sideroachresia). Subsequently, Fe 2+ can accumulate in the body in excessive amounts (secondary hemochromatosis). Although the osmotic resistance of erythrocytes increases, their sensitivity to mechanical damage therefore they are rapidly destroyed in the spleen (early hemolysis). While the heterozygous form (thalassemia minor) is almost asymptomatic, the homozygous form (thalassemia major) can cause death in patients even before puberty. With rare α-thalassemia, fetal death is usually observed, because in the absence of the α-chain, HbF synthesis is also impaired. Hbγ 4 formed in this case in the fetus, and Hbβ 4 synthesized in the postnatal period, obviously, are not able to adequately replace the normal forms of hemoglobin.

Causes of anemia

Weakened or ineffective hematopoiesis

• Lack of iron, vitamin B 12, or folate.
• Renal failure.
• Hypoplasia.
• Anemia of chronic disease

Peripheral causes

• Blood loss.
• hypersplenism
• Hemolysis.

Symptoms and signs of anemia

The clinical picture of anemia is determined by the depth of oxygen deficiency and depends on the degree of anemia, the rate of its increase and the presence of cardiopulmonary pathology in the patient. Fast development anemia (for example, with bleeding) is accompanied by more pronounced symptoms than with its gradual increase. In patients suffering from cardiopulmonary diseases, symptoms of anemia may appear against the background of higher hemoglobin numbers than in individuals with heart healthy and light.

Diagnosis of anemia

When diagnosing anemia, it is necessary to take into account additional factors - pregnancy, living in high mountains, etc.

The diagnosis of anemia should reflect not only the severity of the course, but also indicate its cause. Diagnosis is based on anamnestic data, examination results, determination of all clinical blood parameters, examination of a blood smear and additional research methods.

Anamnesis

• Iron deficiency anemia is the most common form in the world. Important anamnestic data that relate to the gastrointestinal tract; pay attention primarily to signs indicating blood loss. Heavy menstruation is one of the most typical reasons anemia in women. In women, it is necessary to be interested in the course of the menstrual cycle.
• When assessing the nature of nutrition, it is necessary to find out the level of intake of iron and folate in the body. Nutrition may be insufficient and not meet the needs of the body (for example, during pregnancy or during the period of intensive growth of a child or adolescent),
• History of past diseases helps to identify a disease that is accompanied by anemia, such as rheumatoid arthritis, surgery (resection of the stomach or small intestine, which lead to a violation of the absorption of iron and / or vitamin B 12).
• Family history and ethnicity of the patient are important for diagnosis certain forms hemolytic anemia, such as hemoglobinopathies and hereditary spherocytosis.
• Finding out the medications taken by the patient will indicate drugs that can provoke blood loss (for example, aspirin and other anti-inflammatory drugs), hemolysis, or bone marrow aplasia.

Physical examination

Along with the general objective signs of anemia, it is sometimes possible to identify signs indicating the origin of anemia. So, for example, in a patient, you can feel a volumetric formation in the right iliac region- cancer of the caecum; hemolytic anemias are shown by jaundice; deficiency of vitamin B 12 is accompanied by neurological symptoms in the form of peripheral neuropathy, dementia. Sickle cell anemia is sometimes accompanied by ulcers on the legs. Anemia can have several causative factors, and the absence of specific symptoms does not exclude the presence of a "hidden" pathology.

The plan for examining a patient with anemia is often based on the size of red blood cells.

• A normal MCV (normocytic anemia) suggests acute blood loss.
• A small MCV (microcytic anemia) may indicate iron deficiency or thalassemia.
• A large MCV (macrocytic anemia) is a sign of vitamin B12 or folate deficiency.

Diseases of the blood system occupy one of the first positions in terms of prevalence in the overall structure of morbidity. Among them, the undisputed leader is blood anemia. a clear sign anemia is the paleness of the skin. A common cause of anemia is a lack of iron in the human body, which can be caused by frequent blood loss. In more detail what it is, what are the symptoms, types and methods of treating anemia, later in the article.

What is anemia

Anemia is a clinical and hematological syndrome, which is characterized by a decrease in the concentration of hemoglobin in the blood, with a decrease in the number of red blood cells.

Anemia weakens the body's ability to exchange gases; by reducing the number of red blood cells, oxygen transport is disrupted and carbon dioxide. As a result, a person may experience such signs of anemia as a feeling of constant fatigue, loss of strength, drowsiness, and increased irritability.

Severe forms of anemia due to tissue hypoxia can lead to serious complications such as shock states(eg, hemorrhagic shock), hypotension, coronary or pulmonary insufficiency.

Hemoglobin indicators within the permissible norm:

Causes

There are many reasons that can lead to the development of anemia. As an independent disease, anemia rarely develops. Most often, the trigger for the appearance of this syndrome is various diseases of the internal organs or adverse factors that have affected the composition of the blood.

Anemia is based on:

1. Decrease in the amount of hemoglobin;
2. Decrease in the number of red blood cells (occurs in most cases);
3. Signs of impaired blood supply to tissues and their hypoxia (oxygen starvation).

Anemia is also dangerous because it often develops in combination with diseases that can lead to grave consequences. Such diseases include, for example, different kind inflammatory and infectious diseases, malignant tumors.

Anemia can also be caused by severe blood loss. A large number of red blood cells can be lost in the blood during prolonged or unnoticed bleeding. Such bleeding often occurs as a result of diseases of the gastrointestinal system, such as ulcers, hemorrhoids, (inflammation of the stomach) and cancer.

With a lack of oxygen, which is carried by the bloodstream, oxygen starvation can develop. This leads to dystrophy of tissues and organs.

The cause of anemia can be an insufficient amount of iron, vitamin B12 and folic acid in the body, and in rare cases, mainly in children, vitamin C and pyridoxine deficiency. These substances are necessary for the formation of red blood cells in the body.

Symptoms of anemia

Anemia is a dangerous condition. It is insidious, since signs of iron deficiency do not appear immediately. In the initial stages, the body first uses internal reserves and tries to cope with the disease.

The symptoms of anemia are so versatile that they affect almost every functional system of the body. Their severity depends on the degree of decrease in hemoglobin levels.

Therefore, the correct interpretation and comparison of the data available to the patient will make it possible to put correct diagnosis even when initial examination. The situation is quite different with the definition of a specific type of anemia and its causes.

According to generally accepted criteria, anemia in men is indicated by:

• decrease in hemoglobin from 130 g / l;
• the level of erythrocytes is less than 4*1012/l;
• hematocrit below 39%.

For women, these indicators are as follows:

• hemoglobin below 120 g/l;
• erythrocytes less than 3.8*1012 g/l;
• hematocrit - 36% and below.

Common symptoms of anemia include:

• weakness, a significant decrease in performance;
• increased fatigue, irritability, drowsiness for no apparent reason;
• headaches, tinnitus, flashing "flies" before the eyes, dizziness;
• dysuric disorders;
• geophagy (irresistible desire to eat chalk or lime);
• trophic disorders of hair, skin, nails;
• pain in the region of the heart of the type of angina pectoris;
• fainting, tinnitus;
• muscle weakness, body aches.

Explain what anemia is, and what its signs in a person can be on the backbone of the condition of the hair. When the concentration of hemoglobin in erythrocytes decreases, hair loss is observed, nails become brittle.

In elderly patients suffering from ischemic disease heart, with anemia, there is an increase in angina attacks, even after a slight physical exertion.

Symptoms of anemia can develop both gradually and at lightning speed. It all depends on the cause of its occurrence.

Types of anemia

Anemia can be caused by completely different reasons, so it is customary to divide all anemias according to various criteria, including the reasons that cause them.

All types of anemia in humans are divided into:

• arising from blood loss - posthemorrhagic (acute and chronic);
• developed as a result of a violation of the creation of red blood cells or the construction of hemoglobin: iron deficiency, megaloblastic, sideroblastic, anemia of chronic diseases, aplastic;
• caused by increased destruction of red blood cells or hemoglobin - hemolytic.

Common symptoms of anemia of all types are:

• weakness;
• dizziness, "flies" before the eyes;
• palpitations, shortness of breath with habitual physical exertion;
• one of the main symptoms of anemia is pallor of the skin and mucous membranes;
• in the elderly - the occurrence or increase in angina attacks;
• a clinical symptom of anemia in women of reproductive age is menstrual irregularities.

Degrees

There are three degrees of severity of anemia - mild, moderate and severe, depending on the content of hemoglobin and red blood cells in the blood. The lower the indicators, the more severe the form of this painful condition will be.

1. Mild or grade 1 anemia is characterized by a decrease in hemoglobin to 100-120 g / l. At this stage, there are no symptoms. To increase hemoglobin, it is enough to eat right, consume as many iron-containing foods as possible.
2. The middle or stage 2 anemia is accompanied by a decrease in hemoglobin to 70-80 g / l. During this period, the symptoms of anemia are quite pronounced. A person feels general weakness, frequent headaches, dizziness. Medications and proper nutrition will help increase hemoglobin.
3. Severe, or stage 3 - life-threatening. The amount of hemoglobin in the blood is below 70 g / l. At this stage, the patient feels disturbances in the work of the heart, the general condition of the person worsens significantly.

In addition to the severity of the disease, it is customary to distinguish:

• relative anemia - more often characteristic during pregnancy or as part of significant blood loss, characterized by an increase in plasma in the blood;
• absolute anemia - a noticeable decrease in the number of red blood cells and, as a result, a decrease in hemoglobin.

Complications

The consequences of anemia can be quite serious, in some cases it can even be fatal. Most often, anemia causes such problems:

• decreased immunity and, as a result, an increase in ARVI diseases;
• appearance neurological disorders and even deformations of the nervous system;
• swelling of the legs;
• enlargement of the liver and spleen;
• pathology of the heart and blood vessels, etc.

Diagnostics

Diagnosis of anemia includes several important steps:

1. Determining the type of anemia, that is, it is necessary to identify the mechanism that causes a decrease in the level of red blood cells and hemoglobin.
2. Establishing the cause of the disease underlying the anemic syndrome.
3. Conducting laboratory tests, interpreting the results obtained during the examination.

A comprehensive examination for pathology includes a number of laboratory tests:

• General blood analysis. Blood is taken from a finger, the level of hemoglobin is determined.
• Complete blood count. This test allows you to determine the average amount of hemoglobin in a blood cell and the number of reticulocytes. This makes it possible to judge the state of the bone marrow.
• Blood chemistry. In this case, blood is taken from a vein. This study allows you to determine the content of iron in the blood and the level of bilirubin.
• Additional studies, the purpose of which is to study the state of the gastrointestinal tract.

To detect anemia, you need to take a general blood test. The main signs of anemia are deviations in such indicators:

• hemoglobin in the blood does not reach 100 g / l;
• erythrocytes less than 4*1012/l;
• iron content in blood cells is less than 14.3 µmol/l.

If there are such deviations, a more detailed blood test is needed to identify a specific type of anemia.

Treatment of blood anemia

Anemia due to a decrease in red blood cell production that occurs with chronic diseases such as cancer, infections, arthritis, kidney disease, and hypothyroidism is often mild and does not require special treatment. Treatment of the underlying disease should also have a beneficial effect on anemia. In some cases, it may be necessary to cancel drugs that suppress hematopoiesis - antibiotics or other chemotherapeutic agents.

Drugs for anemia should be taken only as directed by a doctor. So, an overdose of iron can lead to constipation,. In a situation where the results of laboratory tests confirm the deficient form of anemia, the patient is prescribed one of the following drugs:

• Sorbifer;
• Ferrum-Lek;
• totem;
• Maltofer;
• Tradiferon.

For the process of hematopoiesis greatest influence provide: minerals:

• iron, copper, zinc;
• B vitamins;
• ascorbic acid;
• vitamins A, D, E.

Treatment should take place exclusively on the recommendation of a doctor, self-medication should not be done, especially during pregnancy, when you can expose the maturing child to additional risks. Only after the examination, the doctor will be able to determine what caused the anemia.

Folk remedies for anemia

Treatment with folk remedies is allowed. However, most folk recipes come down to the simple use of iron-containing vegetables and fruits. Changes in your diet should also be discussed with your doctor. These foods include red meat, legumes, egg yolks, whole grains, and more.

1. With a strong breakdown, it is useful to take a tablespoon of garlic boiled with honey before meals.
2. Pour a teaspoon of red clover inflorescences (red clover) into 1 glass of hot water, boil for 5 minutes, strain. Take 1 tablespoon 4-5 times a day.
3. 6 g of dandelion roots and herbs pour a glass of water, boil for 10 minutes, leave for 30 minutes, take a tablespoon 3 times a day before meals.
4. This recipe is a great combination of taste and health. Eat a small amount every day before meals grated carrot with the addition of sour cream.
5. Rosehip, fruits. 5 tablespoons of crushed fruit per 1 liter of water. Boil 10 minutes. Wrap up for the night. Drink like tea at any time of the day with anything. Perfectly cleans circulatory system improves metabolism. The infusion is rich in vitamin "C" and is used for anemia, scurvy, diseases of the kidneys and bladder, diseased liver, as a tonic.
6. Infusion of rowan fruits is used as a multivitamin remedy for exhaustion and anemia. Pour 2 teaspoons of fruits with 2 cups of boiling water, leave for 1 hour, add sugar to taste and drink 3-4 times a day.
7. Muesli is an additional source of iron. Morning breakfast with muesli contains biologically active substances that regularly accompany the iron molecules encountered on their way into the body. To improve the taste and value of such quick breakfast You can add fruits and nuts to muesli.

Diet

Judging by the name of the disease, the patient needs correction of iron in the blood. It is necessary to take into account the interaction of iron-containing products with other components.

Useful foods for anemia:

1. meat, cream, butter - contain amino acids, proteins;
2. beets, carrots, beans, peas, lentils, corn, tomatoes, fish, liver, oatmeal, apricots, brewer's and baker's yeast - contain trace elements necessary for the process of hematopoiesis;
3. green vegetables, salads and herbs, breakfast cereals - contains a sufficient amount of folic acid;
4. water from mineral springs with a slightly mineralized iron sulfate-hydrocarbonate-magnesium composition of waters, which contributes to the absorption of iron in an ionized form by the body (for example: mineral springs Uzhgorod);
5. supplemented with iron food products(confectionery, bread, baby food, etc.);
6. honey - promotes the absorption of iron;
7. plum juice - contains up to 3 mg of iron in one glass.

The menu is divided into 5 meals.

1st breakfast:

• soft-boiled egg;
• black sweet tea;
• 2 sandwiches with liver pate.

2nd breakfast: apple or pear.

• fresh vegetable salad dressed with vegetable oil;
• borscht with boiled meat;
• a piece of chicken with buckwheat garnish;
• rosehip decoction.

Afternoon snack: diluted pomegranate juice.

• boiled fish with potatoes;
• sweet tea with cookies.

Prevention

Prevention of some types of anemia is quite real. These are, first of all, iron-deficient types. Often such anemia occurs due to a disturbed diet and an unhealthy lifestyle. Therefore, it can be prevented by following the principles:

1. Healthy lifestyle;
2. Periodic medical examinations;
3. Early treatment of chronic pathology;
4. In order to prevent the development of anemia, iron-rich foods (whole grain bread, beans, green vegetables, lettuce, herbs, red lean meat) should be included in the diet.