What is AnemiaWhat is Anemia??

Anemia is having less than normal number of red Anemia is having less than normal number of red blood cells or less hemoglobin than normal in the blood cells or less hemoglobin than normal in the bloodblood..

**Microcytic Anemia: Any abnormal small cells usually Microcytic Anemia: Any abnormal small cells usually resulting from deficiency of Ironresulting from deficiency of Iron..

**Macrocytic or Megaloblastic Anemia: is a blood Macrocytic or Megaloblastic Anemia: is a blood disorder characterized by anemia with red blood disorder characterized by anemia with red blood cells that are larger than normal, usually resulting cells that are larger than normal, usually resulting from deficiency of B12, and Folic Acidfrom deficiency of B12, and Folic Acid..

Hemolytic Anemia: anemia resulting from destruction Hemolytic Anemia: anemia resulting from destruction of reythrocytes (cells that carry oxygen to all part of of reythrocytes (cells that carry oxygen to all part of the body (RBCs)) usually resulting from deficiency of the body (RBCs)) usually resulting from deficiency of Vitamin EVitamin E..

Nutritional AnemiaNutritional Anemia 1- Iron deficiency anemia (microcytic 1- Iron deficiency anemia (microcytic

anemia)anemia) 2- Vitamin B2- Vitamin B1212 and Folate anemia and Folate anemia

(macrocytic or megaloblastic anemia)(macrocytic or megaloblastic anemia) 3- Hemolytic anemia (vitamin E 3- Hemolytic anemia (vitamin E

deficiency)deficiency)

Iron deficiencyIron deficiency Iron deficiency may developed under the following Iron deficiency may developed under the following

condition condition 1- Inadequate intake1- Inadequate intake 2- impaired absorption2- impaired absorption

Vitamin C deficiency, and hypoacidity of Vitamin C deficiency, and hypoacidity of stomach (lack of I.F.) intrensic factorstomach (lack of I.F.) intrensic factor

Excess dietary oxalates and phosphates in Excess dietary oxalates and phosphates in plant foodsplant foods

3- chronic blood loss3- chronic blood loss Parasitic (hookworms, belharziasis, malaria)Parasitic (hookworms, belharziasis, malaria) pathological conditions associated with pathological conditions associated with

chronic bleeding, urinary, gastrointestinalchronic bleeding, urinary, gastrointestinal 4- Frequent blood donation 4- Frequent blood donation

CharacteristicsCharacteristics

Decreased amount of hemoglobin Decreased amount of hemoglobin Small (microcytic), pale-colored Small (microcytic), pale-colored

(hypochromic) red cells(hypochromic) red cells Reduced number of red cellsReduced number of red cells Less plasma iron, and depleted iron Less plasma iron, and depleted iron

stores stores

ManifestationManifestation

Pale skin and mucous membranesPale skin and mucous membranes Manifestation of reduced oxygen-carried power Manifestation of reduced oxygen-carried power

of blood: early fatigue and dyspnoea of blood: early fatigue and dyspnoea (shortness of breath) on exertion(shortness of breath) on exertion

headache, impaired health, lowered efficiency headache, impaired health, lowered efficiency Haemic murmur of heartHaemic murmur of heart Dry brittle flat, then spoon-shaped nailsDry brittle flat, then spoon-shaped nails Low hemoglobin, diminished red cell countLow hemoglobin, diminished red cell count

Susceptible groups. Due to increased Susceptible groups. Due to increased iron neediron need

Preterm infants Preterm infants growing infants and young children growing infants and young children Adolescent girls and females Adolescent girls and females

(pregnant and lactation)(pregnant and lactation) ElderlyElderly

Specific preventionSpecific prevention 1- Adequate nourishment of the vulnerable 1- Adequate nourishment of the vulnerable

group.group. 2- dietary supplementation of the vulnerable 2- dietary supplementation of the vulnerable

group to meet their increased needs (enriched group to meet their increased needs (enriched powder milk, iron preparation)powder milk, iron preparation)

3-Prevention and control of parasitic diseases3-Prevention and control of parasitic diseases 4- Prevention and control pathological 4- Prevention and control pathological

conditions which may be associated with conditions which may be associated with chronic blood loss.chronic blood loss.

5- Nutrition education for selection of 5- Nutrition education for selection of absorbable iron-rich foods. absorbable iron-rich foods.

Megaloblastic AnaemiasMegaloblastic Anaemias A macrocytic anemia in which RBCs development in the bone A macrocytic anemia in which RBCs development in the bone

marrow stops at the stage of megaloblasts. It is includes marrow stops at the stage of megaloblasts. It is includes permicious anaemia due to vit. B12, and anaemia of pregnancy permicious anaemia due to vit. B12, and anaemia of pregnancy due to folic acid deficiency.due to folic acid deficiency.

Susceptible groupSusceptible group 1- Folacin deficiency 1- Folacin deficiency

(pregnant, lactating)(pregnant, lactating) 2- B12 deficiency2- B12 deficiency

Vegetarians Vegetarians subjects of atrophied stomach mucosa, or gastrectomy subjects of atrophied stomach mucosa, or gastrectomy InfectionInfection Cases of malabsorption syndrome Cases of malabsorption syndrome

Specific Prevention Of Megaloblastic Specific Prevention Of Megaloblastic

AnaemiasAnaemias 11 - -Anemia of pregnancyAnemia of pregnancy::

* * Adequate feeding during pregnancy and lactation, toAdequate feeding during pregnancy and lactation, to

satisfy increased requirement of B12 and Folic Acidsatisfy increased requirement of B12 and Folic Acid

+ + supplementssupplements

22 - -Pernicious anemiaPernicious anemia::

* * Balanced diet, with reasonable amount of animal foodBalanced diet, with reasonable amount of animal food..

* * Supplementing diet of vegetarian with B12Supplementing diet of vegetarian with B12..

* * Compensation for lacking Intrinsic Factor IF which isCompensation for lacking Intrinsic Factor IF which is

necessary for absorption of Vitamin B12 in case ofnecessary for absorption of Vitamin B12 in case of

atrophic mucosaatrophic mucosa

* * Prevention and control of infectionPrevention and control of infection..

Normal Values of the Normal Values of the hemogram (Figure 1hemogram (Figure 1

TestWomenMen

Hg (g/dl)12-1613 ,5-17 ,7