During the physical examination or medical treatment, blood routine examination is the most common laboratory examination item. Children often have children who are told by doctors that blood routine examination prompts anemia . So what is anemia? What factors cause it? What should I pay attention to? Let's learn more about it below.
What is anemia?
"Anemia" is a clinical symptom, which can be one of the main clinical manifestations of hematologic diseases, or a symptom accompanied by non-hematologic diseases, such as tumors, infections, autoimmune disease , etc. Anemia generally refers to the amount of red blood cell count (RBC), hemoglobin (Hb) and hemocytometer (heMAtocrit, Hct) in the blood unit volume of peripheral blood below the low limit of the reference range. It indicates that the hyperplasia and consumption of red blood cells in the human body is out of balance, or insufficient production or excessive consumption or at the same time, causing the destruction of red blood cells to exceed the hematopoietic capacity of the bone marrow. The general criteria for anemia are: What laboratory tests are there for Hb
in adult males?
Anemia laboratory examination mainly includes 1. Peripheral blood test: erythrocyte count, hemoglobin amount, hematocrit and red blood cell-related parameters. Another important indicator is reticulum erythrocyte count, which can determine the hematopoietic function of the bone marrow erythrocyte. Peripheral blood reticulocytes represent the transition stage between red blood cell precursors and mature red blood cells, and normal human reticulocytes account for 0.5% to 1.5% of the total number of red blood cells. 2. Bone marrow examination: Exclude blood system diseases and tumor bone marrow metastasis, causing inhibition of erythrosis. 3. Biochemical examination: serum iron metabolism and folic acid and other examinations to evaluate whether there is nutritional deficiency; 4. Immunological examination: autoantibodies detection excludes autoimmune diseases such as systemic lupus erythematosus ; 5. Etiology examination: Plasmodium . Hookworm infection can cause anemia; 6. Other special tests include hemoglobin electrophoresis and gene detection and other diagnosis of hereditary erythrocyte diseases.
What are the treatments for anemia?
After clinical discovery of anemia, it is generally active to treat the primary disease and triggers of anemia. The treatment methods that are often used in clinical practice are usually divided into the following categories: 1. Supplementary hematopoietic raw materials: mainly seen in iron deficiency anemia and trophic megaucytic anemia. 2. Stimulate hematopoiesis: Drugs that stimulate erythrocyte production also have certain therapeutic effects on renal anemia and some chronic disease anemia. Androgens have the effect of stimulating bone marrow hematopoiesis. 3. glucocorticoid and other immunosuppressant are mainly used for the treatment of severe aplastic anemia, cyclin A and other drugs. 4. Blood transfusion: Anemia caused by acute massive blood loss should be transfusion quickly to supplement blood volume. If severe aplastic anemia is severe, blood transfusion should also be required. 6. Splenicectomy: For hereditary diseases, such as hereditary spherical erythrocythemia, splenectomy is the first treatment measure. 7. Allogeneic hematopoietic thousand cell transplantation is mainly used for aplastic anemia and anemia caused by genetic factors.
What are the common types of anemia in children?
The most common type of anemia in children is nutritional anemia, mainly including iron deficiency anemia (IDA) and megaloblastic anemia (MA).
Iron deficiency anemia is a common nutritional anemia in children. Generally, due to the decrease in the body's iron intake, excessive iron loss and increased iron demand, the body's iron reserves are exhausted, resulting in reduced hemoglobin synthesis. Patients with mild anemia can be ortho-cell orthopigmented anemia. As the anemia worsens, the typical case is small-cell hypopigmented anemia, and the reticulocyte count is normal or mildly increased. leukocyte count is normal, and platelet is normal or increased. The laboratory can differentially diagnose anemia caused by other chronic diseases through iron metabolism, bone marrow cytology, and iron staining . Children usually start slowly, mild anemia may not have any conscious symptoms, moderate or severe anemia may cause dizziness, fatigue, palpitations, shortness of breath, pale or sallow face after activity.Special manifestations of iron deficiency include dry hair, angular stomatitis , glossitis , spoon-shaped nails (renaline), digestive tract manifestations, etc. (loss of appetite, nausea, constipation). The diagnosis of iron deficiency anemia needs to be combined with the medical history. For infants and young people, since picky and partial eating are common, we should pay attention to whether there is insufficient iron intake. Since the iron absorption site is at the upper end of the duodenum and jejunum, iron absorption disorders can occur if the disease or surgery involving the site are involved. The treatment of iron deficiency anemia includes etiology treatment and supplementation with iron agent . The method of supplementing iron is mainly through oral administration and injection, with oral administration as the first choice. Ferrous sulfate controlled-release tablets have less gastrointestinal reactions and are more clinically used. Currently, the most commonly used in clinical practice is ferrous succinate, which has high bioavailability and fewer adverse reactions. After the anemia is corrected, you need to continue taking it for 3 to 6 months to supplement the stored iron in the body, otherwise it will easily recur. Iron injection is limited to those who cannot tolerate oral iron, have gastrointestinal diseases or affect the absorption of iron after gastrointestinal surgery. Iron treatment needs to be taken under the guidance of a physician. Infants and young children advocate breastfeeding and timely add foods with high iron content. Teens should correct their negative eating habits of partial eating.
Megacellular anemia is anemia caused by nucleic acid metabolism due to various reasons due to folic acid and/or vitamin B12 deficiency in the body. Since folic acid and vitamin B12 are essential substances for cell metabolism in the body, megaloblastic anemia can show systemic symptoms: pale face, dizziness, fatigue, palpitations and shortness of breath after activity, etc. The symptoms of the digestive tract can be manifested as repeated glossitis, smooth tongue, loss of taste and appetite, and abdominal distension, diarrhea or constipation. Vitamin B12 deficiency can cause symptoms of nervous system , and the lesions mainly involve the spinal cord and peripheral nerves. For children with malignant diseases, the use of certain drugs that inhibit DNA synthesis, such as chemotherapy drugs such as cytarabine, etc. can also cause melanocytosis anemia. The laboratory conducted routine blood tests, which showed that large-cell orthopigmented anemia, and the granulocyte and platelet counts may also be reduced to varying degrees. A large number of large red blood cells can be seen in blood smears, and the central calm area is expanded. If bone marrow aspiration is performed, all the cells of the bone marrow hematopoietic system will undergo megacellular changes, but the red system is the most significant. Serum folic acid and vitamin B12 tests can be used as the initial screening test for this disease, and combined with blood and bone marrow examinations, it can clearly diagnose it. Diagnosis of megaloblastic anemia is mainly combined with medical history, which is often related to incorrect eating habits and cooking habits. Adolescent patients should pay attention to asking whether they have a history of partial eating and whether they have taken drugs that can cause melanocytic anemia.
Other hereditary red blood cell diseases, including hereditary hemoglobin disease (thalassemia), red blood cell enzyme defect (commonly known as " broad bean disease "), and red blood cell membrane defective diseases. The relatives of ordinary patients have a history of anemia, and the severity of anemia worsens over time. It is necessary to clarify the diagnosis based on clinical manifestations and genetic examinations. When clinical symptoms are severe, splenectomy and stem cell transplantation are considered to help improve the quality of life of patients.
Children are found to have anemia when they go to medical treatment, so there is no need to worry. Under the guidance of clinicians, they will improve laboratory examinations and rule out malignant diseases such as acute leukemia and tumors. Common diseases are caused by nutritional deficiency. In daily diet, children should pay attention to intake of deficiency, folic acid and vitamin B12, and advocate healthy eating and cooking habits, which will definitely grow up healthily.
Author of this article: Ma Juan Attendant physician of the Laboratory Department of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine
