There are three possible types of anemia: sideroblastic anemia, iron deficiency anemia, and thalassemia. Thus, in order to treat the patient properly, it is important to identify the type first. Taking all the symptoms that Ann reported into consideration, it is possible to come to the conclusion that she suffers from iron loss.
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Justification and Further Action
Low blood pressure, shortness of breath, and low energy levels are the factors that support the fact that the condition is caused by iron deficiency. During each menstrual period, the patient suffers from menorrhagia accompanied by excessive intake of aspirin, which inevitably irritates the gastrointestinal mucosa (Camaschella, 2015). If the situation persists, it can result in chronic mucosal microhemorrhage.
In order to verify the diagnosis, the oral iron replacement must be provided. If in 1 month the hemoglobin deficiency, from which the patient suffers, disappears, it will mean that the diagnosis was correct. Furthermore, it is highly important to identify the major source of bleeding and to find a replacement for aspirin to relieve pain (DeLoughery, 2017). The patient also needs iron supplements that she could take without complications for more than 1 year.
Another factor supporting the diagnosis is that iron deficiency anemia is the most widespread type, which mostly occurs in women of the childbearing age. This loss of iron happens to owe to a heavy blood loss during menstruation. It is typically connected with the inability of the body to absorb iron properly (Camaschella, 2015). The symptoms can be rather mild or undetectable at first (as it is in the case with Ann), which makes it difficult to identify the problem. According to the American Society of Hematology, the majority of people do not realize that they have any problems until they do all the necessary screenings (DeLoughery, 2017).
The symptoms that allow stating that Ann has iron-deficiency anemia include:
- general fatigue that does not depend on physical activity (it was the beginning of the golf season when the patient realized that she was extremely tired despite the fact that no excessive effort was made on her behalf);
- weakness (Ann reported feeling weak and lacking energy);
- shortness of breath;
- low hemoglobin (Camaschella, 2015).
There are several most common reasons the patient might suffer from this type of anemia. First and foremost, it can be connected with an inadequate intake of iron. Both consuming too little or too much of it harm one’s body. Yet, in the majority of cases, patients simply do not eat foods that are rich in iron. Second, heavy bleeding during menstruation may cause the loss that cannot be compensated by consuming the right products and requires medical treatment. Besides, regular use of painkillers (including aspirin mentioned in the case) causes bleeding or ulcers in the stomach, which are also associated with iron loss (DeLoughery, 2017). Besides, it is not clear from the case if the body of the patient is able to absorb the full amount of iron that it needs for proper functioning. In some cases, this ability can be limited.
Although some screenings were made, the final diagnosis is impossible until the following test results are obtained:
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- complete blood cell test;
- red blood cells;
- white blood cells;
- platelets (DeLoughery, 2017).
Despite the fact that the presence of the condition can be identified even by the results of the complete blood test, other tests are typically required to find out if anemia is light or severe. This will determine which course of treatment will be selected.
Camaschella, C. (2015). Iron-deficiency anemia. New England Journal of Medicine, 372(19), 1832-1843.
DeLoughery, T. G. (2017). Iron deficiency anemia. Medical Clinics, 101(2), 319-332.