Introduction
Anemia is a condition that develops as a result of low hemoglobin (Hb) and hematocrit (HCT) contents, as well as a low erythrocyte count. Hb is a protein contained in erythrocytes. It is responsible for the reception of oxygen in the lungs, its transportation to various body cells, and the reverse transportation of the carbon dioxide to the lungs. The normal level of Hb content in the blood is 12-15,5 g/dl in females, and 12,5-17,5 g/dl in males (Klimas, 2015). HCT is an important index for the identification of anemia as well. It shows the ratio of blood cells’ volume (erythrocytes) to the entire blood volume in an organism. For women, HCT norm is about 34-44,5%, and for men – 38,8-50% (Klimas, 2015). Lastly, the norm of erythrocyte count for females is equal to 3,9-5,0 x 10/mm, and for males – 4,3-5,7 x 10/mm (Klimas, 2015).
Analysis
Ms. A has lowered laboratory values in all the three parameters: Hb – 8 g/dl, HCT – 32%, and erythrocyte count – 3.1 x 10/mm. It means she has anemia. Based on the analysis of other symptoms, such as weakness, reduced level of energy, shortness of breath, the presence of microcytic and hypochromic cells in the blood, it is possible to say that she has iron-deficiency anemia. In the given type of disorder, the size of erythrocytes decreases due to the reduced concentration of Hb in them. Normally, the size of these cells is approximately 80-100 microns, but if a person has microcytic, iron deficiency anemia, the size of erythrocytes becomes lower than 80 microns (Johnson-Wimbley & Graham, 2011).
The color index in the cells also depends on the content of Hb in them. The presence of hypochromic cells indicates low Hb value. When it happens, erythrocytes have an uneven pale pink color with clearly defined bright spots in the middle (“Red blood cell (RBC) color variation,” 2017). This color is abnormal for the red blood cells – the normochromic cells always have even, moderate pink color, slightly light in the center (“Red blood cell (RBC) color variation,” 2017). The presence of hypochromic cells is typical for iron deficiency anemia, and the combination of hypothermia with microcytosis is frequent in patients with this condition (Naigamwalla, Webb, & Giger, 2012).
Iron deficiency anemia can be caused by many reasons including congenital microelement deficiency, a metabolic disease, improper diet, etc. In the case of Ms. A, iron deficiency may be provoked by the partial loss of blood during her menses. Menstruation is one of the major factors of iron deficiency in women. When the loss of the microelement is not compensated through food intake, anemia occurs (Johnson-Wimbley & Graham, 2011).
Blood loss provokes a misbalance in the blood content. The content of iron in the blood is very insignificant but, usually, it is quickly replenished by iron delivered to the bone marrow and recycled in the reticuloendothelial system (Johnson-Wimbley & Graham, 2011). When the content of the microelement is insufficient in the organism, its concentration in the plasma decreases, and the required amount of iron does not enter the bone marrow for Hb synthesis and, as a result, anemia develops.
When anemia is provoked by iron deficiency, it is important to intervene in the dietary habits of the patient in order to ensure that the food contains enough dietary heme iron which can be well adsorbed (Johnson-Wimbley & Graham, 2011). Secondly, it can be recommended for Ms. A to undergo gynecological treatment aimed to reduce heavy menstrual bleeding.
References
Johnson-Wimbley, T. D., & Graham, D. Y. (2011). Diagnosis and management of iron deficiency anemia in the 21st century. Therapeutic Advances in Gastroenterology, 4(3), 177–184.
Klimas, L. (2015).Explain the tests: Complete blood count (CBC) – Red cell indices (Part 4).
Naigamwalla, D. Z., Webb, J. A., & Giger, U. (2012). Iron deficiency anemia. The Canadian Veterinary Journal, 53(3), 250–256.