Microcytic hypochromic anemia

Introduction

Introduction to small cell hypochromic anemia According to the size of red blood cells and the content of hemoglobin in red blood cells, anemia is classified. Small cell hypochromic anemia is small in red blood cells, and the hemoglobin content in red blood cells is lower than normal. basic knowledge The proportion of illness: 0.02% Susceptible people: no specific population Mode of infection: non-infectious Complications: intracranial hypertension syndrome

Cause

Small cell hypochromic anemia

The developing red blood cells require iron, protoporphyrin and globin to synthesize hemoglobin, and hemoglobin synthesis is insufficient to cause hypopigmentation anemia. There is still a different view on the relationship between iron deficiency and infection, macrophage function and spleen during iron deficiency. The activity of natural killer cells is obviously disordered. The function of myeloperoxidase and oxygen respiratory burst of neutrophils is reduced, the production of lymphocyte transformation and migration inhibitory factors is blocked, and the cellular immune function is decreased. However, others emphasize that iron is also a bacterial growth. Needed, it is believed that iron deficiency has a certain protective effect on the body, and iron is more prone to infection than iron deficiency.

Prevention

Small cell hypochromic anemia prevention

1. Do a good job in feeding guidance: promote breastfeeding, and timely add supplemental foods with high iron content and high iron absorption rate, such as liver, lean meat, fish, etc., and pay attention to the reasonable mix of diets, and appropriate iron supplements for pregnant and lactating women. .

2, infant foods add appropriate amount of iron for reinforcement.

3, for premature infants, low birth weight infants should be given early iron prevention.

4. Large-scale parasite control should be carried out in the endemic area of hookworms.

5, timely cure a variety of chronic gastrointestinal bleeding diseases.

Complication

Small cell hypochromic anemia complications Complications intracranial hypertension syndrome

Increased intracranial pressure, easy to infection, such as accompanied by stomatitis, glossitis, etc., anemia can be complicated by anemia.

Symptom

Small cell hypochromic anemia symptoms Common symptoms Red blood cells are low abdominal distension and nausea

1. Transferrin deficiency: also known as no transferrinemia, refers to the lack or lack of transferrin in the patient's plasma due to genetic defects. There is a large amount of iron in the liver, spleen, and pancreas, and no iron is available in the bone marrow to synthesize hemoglobin. This disease is very rare.

2, primary pulmonary hemosiderosis and pulmonary and renal hemorrhagic syndrome: primary pulmonary hemosiderosis is a rare iron metabolism abnormal disease, characterized by extensive pulmonary capillary hemorrhage, alveolar There is a large amount of hemosiderin, accompanied by iron deficiency anemia. The main clinical manifestations are recurrent hemoptysis, shortness of breath and anemia. Pulmonary and renal hemorrhagic syndrome, also known as Goodpasture syndrome, is also a rare disease. Similar to primary pulmonary hemosiderin, it is characterized by recurrent episodes of hemorrhage in the alveoli and iron deficiency anemia, but also lesions and manifestations of glomerulonephritis.

3, chronic infectious anemia and other: chronic infectious anemia, although the serum iron is reduced, but the total iron binding capacity will not increase or decrease, so the transferrin saturation is normal or slightly increased. Serum ferritin is often elevated. The number of iron granulocytes in the bone marrow decreased, and the hemosiderin particles increased significantly. Others such as lead poisoning can cause small cell hypochromic anemia.

Examine

Examination of small cell hypochromic anemia

1, blood

Typical small cell hypochromic anemia (MCV<80fl, MCH<27pg, MCHC<30%), the degree of erythrocyte index change is related to the time and extent of anemia, and the red blood cell width distribution (RDW) is diagnosed in iron deficiency anemia. The significance is difficult to determine, the normal is (13.4 ± 1.2)%, the iron deficiency anemia is 16.3% (or > 14.5%), the specificity is only 50% ~ 70%, the red blood cells stained in the blood film, the center is lightly dyed The area is enlarged, the size is different, most of the reticulocytes are normal or slightly increased, the white blood cell count is normal or slightly reduced, the classification is normal, the platelet count is often high in patients with bleeding, and is mostly low in infants and children.

2, bone marrow

Bone marrow examination is not necessary, unless it is necessary to distinguish from anemia of other diseases, bone marrow smears show hyperplasia, young red blood cells are proliferated, early red and young red blood cells are increased, chromatin particles are dense, cytoplasm is less, hemoglobin formation Poor, granulocyte and megakaryocyte cell lines are normal, iron granules are few or missing, and extracellular iron is absent.

Diagnosis

Diagnosis and identification of small cell hypochromic anemia

The average red blood cell volume (MCV), red blood cell mean hemoglobin (MCH), and red blood cell mean hemoglobin concentration (MCHC) are all below the normal value, which can be diagnosed as "small cell hypochromic anemia." That is, MCV<80fl, MCH<28pg, MCHC<32%.

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