Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia.
Iron deficiency anemia occurs when your body does not have enough iron. Iron helps make red blood cells.
Causes
Iron deficiency anemia is the most common form of anemia.
Red blood cells bring oxygen to the body's tissues. Healthy red blood cells are made in your bone marrow. Red blood cells circulate through your body for 3 to 4 months. Parts of your body, such as your spleen, remove old blood cells.
Iron is a key part of red blood cells. Without iron, the blood cannot carry oxygen effectively. Your body normally gets iron through your diet. It also reuses iron from old red blood cells.
You get iron deficiency anemia when your body's iron stores run low. This can occur because:
· You lose more blood cells and iron than your body can replace
· Your body does not do a good job of absorbing iron
· Your body is able to absorb iron, but you are not eating enough foods that contain iron
· Your body needs more iron than normal (such as if you are pregnant or breastfeeding)
Bleeding can cause iron loss. Common causes of bleeding are:
· Heavy, long, or frequent menstrual periods
· Cancer in the esophagus, stomach, small bowel, or colon
Iron supplements (most often ferrous sulfate) are needed to build up the iron stores in your body. Most of the time, your doctor or nurse will measure your iron levels before starting supplements.
If you cannot take iron by mouth, you may need to take it through a vein (intravenous) or by an injection into the muscle.
Pregnant and breastfeeding women will need to take extra iron because they often cannot get enough iron from their normal diets.
Your hematocrit should return to normal after 2 months of iron therapy. You will need to keep taking iron for another 6 to 12 months to replace the body's iron stores in the bone marrow.
Iron-rich foods include:
· Chicken and turkey
· Dried lentils, peas, and beans
· Fish
· Meats (liver is the highest source)
· Peanut butter
· Soybeans
· Whole-grain bread
Other sources include:
· Oatmeal
· Raisins, prunes, and apricots
· Spinach, kale, and other greens
Outlook (Prognosis)
With treatment, the outcome is likely to be good. However, it does depend on the cause.
When to Contact a Medical Professional
Call your health care provider if:
· You have symptoms of iron deficiency
· You notice blood in your stool
Prevention
A balanced diet should include enough iron. Red meat, liver, and egg yolks are high sources of iron. Flour, bread, and some cereals are fortified with iron. If advised by your doctor, take iron supplements if you are not getting enough iron in your diet.
Hemophilia A is a hereditary bleeding disorder caused by a lack of blood clotting factor VIII. Without enough factor VIII, the blood cannot clot properly to stop bleeding.
Blood clots (fibrin clots) are the clumps that result when blood coagulates.
Hemophilia A is caused by an inherited X-linked recessive trait, with the defective gene located on the X chromosome. Females have two copies of the X chromosome, so if the factor VIII gene on one chromosome doesn't work, the gene on the other chromosome can do the job of making enough factor VIII. Males, however, have only one X chromosome, so if the factor VIII gene on that chromosome is defective, they will have hemophilia A. Thus, most people with hemophilia A are male.
If a woman has a defective factor VIII gene, she is considered a carrier. This means the defective gene can be passed down to her children. In a woman who carries the defective gene, any of her male children will have a 50% chance of having hemophilia A, while any of her female children will have a 50% chance of being a carrier. All female children of men with hemophilia carry the defective gene. Genetic testing is available for concerned parents.
Risk factors for hemophilia A include:
Family history of bleeding
Being male
Rarely, adults can develop a bleeding disorder similar to hemophilia A. This may happen after giving birth (postpartum), in people with certain autoimmune diseases such as rheumatoid arthritis, in people with certain types of cancer (most commonly lymphomas and leukemias), and also for unknown reasons (called "idiopathic"). Although these situations are rare, they can be associated with serious, even life-threatening bleeding.
The severity of symptoms vary. Bleeding is the main symptom of the disease and sometimes, although not always, occurs if an infant is circumcised.
Additional bleeding problems are seen when the infant starts crawling and walking.
Mild cases may go unnoticed until later in life when they occur in response to surgery or trauma. Internal bleeding may happen anywhere, and bleeding into joints is common.
Symptoms may include:
Bleeding into joints, with associated pain and swelling
If the patient is the first person in the family to have a suspected bleeding disorder, he or she will undergo a series of tests called a coagulation study. Once a disorder has been identified, other family members will need less testing to diagnose the disorder.
Standard treatment involves replacing the missing clotting factor. The amount of factor VIII concentrates needed depends on the severity of the bleeding, the site of the bleeding, and the size of the patient.
Mild hemophilia may be treated with desmopressin (DDAVP), which helps the body release factor VIII that is stored within the lining of blood vessels.
To prevent a bleeding crisis, people with hemophilia and their families can be taught to give factor VIII concentrates at home at the first signs of bleeding. People with severe forms of the disease may need regular preventive treatment.
Depending on the severity of the disease, DDAVP or factor VIII concentrate may be given before having dental extractions or surgery in order to prevent bleeding.
Immunization with hepatitis B vaccine is necessary because of the increased risk of exposure to hepatitis due to frequent blood infusions.
Patients who develop an inhibitor to factor VIII may require treatment with other clotting factors such as factor VIIa, which can help with clotting even without any factor VIII.
The outcome is usually good with treatment. Most people with hemophilia are able to lead relatively normal lives.
Patients with hemophilia should establish regular care with a hematologist, especially one who is associated with a hemophilia treatment center. The ability to have quick and easy access to medical records documenting the patient's history of factor IX levels, factor transfusions (including the type and amount), complications, and amount of any inhibitors can be lifesaving in the event of an emergency situation.
Chronic joint deformities may occur from bleeding into joints. This complication can be managed by an orthopedic specialist. However, joint replacement may be needed.
Intracerebral hemorrhage is another possible complication.
Repeated transfusions may slightly raise the risk for HIV and hepatitis , however, continued improvements in blood screening procedures makes blood products safer than ever.
