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ANEMIA
I. ANEMIA
 Anemia is a condition in which the number of red blood cells or the hemoglobin concentration within them
is lower than normal.
o Hemoglobin is needed to carry oxygen
 Anemia is defined as a hemoglobin concentration below a specified cut-off point:
o depends on the age, gender, physiological status, smoking habits and altitude at which the
population being assessed lives.
 According to the World Health Organization (WHO), anemia is defined as Hemoglobin (Hb) levels:
o < 12.0 g/dL females
o < 13.0 g/dL males
II. Classifications based on Age and Severity

III. Prevalence
 According to WHO data, anemia affects:
o 1.62 billion people (1.50–1.74 billion)
o corresponds to 24.8% of the world population (22.9– 26.7%)
o global data cannot describe the real burden of the problem because anemia has different
prevalence and causes in different settings
 The highest prevalence of anemia is recorded in children younger than 4 years
 Prevalence in subjects older than 65 years varies from 11%–60%
IV. Anemia and Public Health
 Anemia is a serious global public health problem
 Particularly affects young children and pregnant women
 WHO estimates of ANEMIA:
o 42% of children less than 5 years of age
o 40% of pregnant women worldwide
 Anemia is an indicator of both poor nutrition and poor health
 The most common causes of anemia include nutritional deficiencies, particularly iron deficiency
V. Hematopoiesis
 Hematopoiesis is the process by which the formed elements of blood are produced.
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 The process is regulated through a series of steps beginning with the hematopoietic stem cell.
 Stem cells are capable of producing red cells, all classes of granulocytes, monocytes, platelets, and the cells
of the immune system.

VI. Clinical Presentations

 General Features

 Specific signs are associated with particular types of anemia:

o Spoon nail with iron deficiency,
o Leg ulcers with sickle cell anemia
o Jaundice with hemolytic anemia
o Bone deformities in thalassemia major
 Presence or absence of clinical feature depends on:
o Speed of onset:
 Rapidly progressive anemia causes more symptoms than slow onset anemia due to lack of
compensatory mechanisms: cardiovascular system, BM & O2 dissociation curve
o Severity:
 Mild anemia :no symptoms usually o Symptoms appear if Hb less than 9 g/dL
o Age:
 Elderly tolerate anemia less than young patient
VII. Approach to Patients
 History
o Symptoms: bleeding, fatigue, malaise, fever, weight loss, night sweats, and other systemic
symptoms
o Symptoms related to other disorders commonly associated with anemia
o Nutritional history
o Drugs or alcohol intake
o Family history of anemia
o Geographic backgrounds and ethnic origins
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 PE
o Skin and mucous membranes: PALLOR (haemoglobin <8-10 g/dL)
o Clues to the mechanisms of anemia: infection, blood in the stool, lymphadenopathy, splenomegaly,
lymphadenopathy, or petechiae
o Forceful heartbeat, strong peripheral pulses, and a systolic “flow” murmur.
o Past laboratory measurements