1. Anemic syndrome
REASONS: anemia of any genesis, including anemia with hemoblastosis
Symptoms common to any anemia:
muscle weakness, reduced ability to work
dizziness, "flies" before the eyes
fainting
shortness of breath and palpitations when walking (decreased exercise tolerance)
pallor (alabaster with blood loss, greenish with iron deficiency (chlorosis), slightly icteric with B-12, folio-deficient anemia, with a lemon-yellow tint with hemolytic anemia) of the skin and sclera, mucous membranes.
tachycardia, systolic functional noise above the apex, pulmonary trunk. Veins: the noise of the top on vv.juqularis, etc.
a decrease in the content of red blood cells, hemoglobin, reticulocytes, the appearance of altered forms of red blood cells (micro-, macrocytes, poikilocytes, hypo-hyperchromia, etc.).
2. Sideropenic syndrome (iron deficiency)
REASONS: repeated blood loss, insufficient intake of iron with food, malabsorption, increased consumption, redistribution, hemoglobinopathies. SYMPTOMS:
complaints of difficulty swallowing dry and solid foods (sideropenic dysphagia), pain and burning of the tongue, impaired taste and appetite (the need to eat chalk, clay, coal, earth, minced meat), a perversion of smell (addiction to the smell of kerosene, acetone, etc. )
fetid rhinitis
trophic changes in the skin, mucous membranes, hair and nails: the skin is dry, slightly peeling, tans poorly, the hair is split off, it turns gray early and falls out, the nails flatten, lose their luster, have transverse striation, they break easily, spoon-like deformations of nails (koilonychia) form, ulcerations and cracks appear in the corners of the mouth, angular stomatitis, pain and burning in the tongue (glossitis)
urinary incontinence with coughing, laughing
erythrocyte hypochromia, microcytosis
decreases the level of serum iron and the total iron binding capacity of the plasma (normal 30.6
84.6 mmol / l) and increases the latent iron binding capacity (normal 16 - 44 μmol / l)
Iron deficiency anemia
CAUSES.
Inadequate intake of iron with food (strict diet, lack of fruits, meat).
Violation of iron absorption in the intestines and stomach (gastritis, enterocolitis).
Increased consumption, redistribution of iron (children, girl, pregnant, lactating women, severe inflammatory processes)).
Repeated blood loss: nasal, gastric, rectal, renal, pulmonary, uterine bleeding, in closed cavities and tissues.
Iron is not absorbed by red blood cells (hemoglobinopathies).
anemic
sideropenic.
Blood:
106
Red blood cells: less than normal. Micro, poikilo, aniso, schizocytes.
HB is below normal, a decrease in the number of reticulocytes.
Red blood cell hypochromia - color indicator (MCH) - below normal,
The content of serum iron, ferritin is reduced to less than 30 μg / l, the percentage of transferrin saturation with iron is less than 25%.
Bone marrow:
Sideroblasts <20%
B-12, folic deficiency anemia
CAUSES.
- malnutrition (lack of B-12)
- atrophic gastritis, gasterectomy
- enteritis, enterectomy (B-12, F.K. is not absorbed)
- increased consumption of B-12 and F.K. (pregnancy) - inferiority of erythroblasts (do not digest B-12, F.K.) Symptoms
Leading syndromes: - anemic;
- neurological - only with B-12 dependent anemia (gait unsteadiness, muscle weakness, pleurisy, polyneuropathy, due to the development of funicular myelosis;
- damage to the gastrointestinal tract - atrophic, inflammatory processes, resection of the stomach, small intestine, glossitis (papillae are erased, the surface is smooth, bright pink - ―varnish‖, ―raspberry‖ tongue), hepatomegaly, splenomegaly.
Blood.
- Red blood cells. Macrocytosis, megaloblasts, aniso- and poikilocytosis. - Nv. below normal, decreased reticulocyte count.
- Hyperchromia of red blood cells - raising color index (MCH). - Polysegmentation of neutrophil nuclei.
- Jolie Taurus, Kebot rings (the remains of the nucleus in red blood cells). - Indirect bilirubin over 34 μmol / L
- Raw iron> normal. The content of Vit B-12 and folic acid is reduced. Bone marrow.
- Megaloblasts.
Pic 7.1 Anemia blood rates
107