Page 40 - Learnwell EVS
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emia 1. A few symptomes and syndromes
1
– A naem ia is d efined as a haem o glo bin level belo w reference values . It is a frequent
1
sy m p to m in tro p ical settings wh ere 1 0 to 2 0 % o f the p o p ulatio n p resent with
Hb
levels less than 1 0 g/ d l.
– A naem ia is caused by :
• decreased production of red blood cells: nutritio nal iro n and / o r fo lic acid d eficiency ,
d ep ressed bo ne m arro w functio n, so m e infectio ns (H IV , visceral leishm aniasis etc.);
• loss of red blood cells: acute o r chro nic haem o rrhage (ancy lo sto m iasis etc.)
• increased destruction of red blood cells (haemolysis): m alaria; infectio ns o r the into lerance
o f certain d rug s by p atients w ith G 6 P D d eficiency ( p rim aquine, d ap so ne,
co trim o xaz o le, nalid ixic acid , nitro furan d erivatives etc.) ; h aem o glo bino p ath ies
(sick le cell d isease, thalassaem ias); certain bacterial and viral infectio ns (H IV ).
– In tro p ical settings, the causes are o ften interlink ed , the two m o st co m m o n causes are
nutritio nal d eficiencies and m alaria. T he gro up s m o st at risk are child ren and y o ung
wo m en, p articularly d uring p regnancy .
– A naem ia in itself is no t an ind icatio n fo r transfusio n. M o st anaem ias are w ell
to lerated and can be co rrected with sim p le aetio lo gical treatm ent.
Clinical features
– C o m m o n signs o f anaem ia: p allo r o f the co njunctivae, m uco us m em branes, p alm s
of
h and s and so les o f feet; fatigue, d iz z iness, o ed em a in the lo wer lim bs, d y sp no ea,
tachy card ia, heart m urm ur.
– S igns th at anaem ia m ay be im m ed iately life th reatening: sw eating, th irst, co ld
extrem ities, tachy card ia, resp irato ry d istress and sho ck .
– L o o k fo r signs o f a sp ecific p ath o lo gy : ch eilo sis, nutritio nal d eficiency glo ssitis,
haem o ly tic jaund ice, signs o f m alaria (see p age 1 3 1 ) etc.
Laboratory
– H aem o glo bin level (o r if haem o glo bin is no t available, haem ato crit)
– T hick and thin blo o d film s o r rap id test if m alaria is susp ected
Normal values: > 13 g/dl in men; > 12 g/dl in women; > 11 g/dl in pregnant women; > 13.5 g/dl in newborns;
1
> 9.5 g/dl in infants from 2 to 6 months; > 11 g/dl in children from 6 months to 6 years; > 11.5 g/dl in children
from 6 to 12 years.
1
– A naem ia is d efined as a haem o glo bin level belo w reference values . It is a frequent
1
sy m p to m in tro p ical settings wh ere 1 0 to 2 0 % o f the p o p ulatio n p resent with
Hb
levels less than 1 0 g/ d l.
– A naem ia is caused by :
• decreased production of red blood cells: nutritio nal iro n and / o r fo lic acid d eficiency ,
d ep ressed bo ne m arro w functio n, so m e infectio ns (H IV , visceral leishm aniasis etc.);
• loss of red blood cells: acute o r chro nic haem o rrhage (ancy lo sto m iasis etc.)
• increased destruction of red blood cells (haemolysis): m alaria; infectio ns o r the into lerance
o f certain d rug s by p atients w ith G 6 P D d eficiency ( p rim aquine, d ap so ne,
co trim o xaz o le, nalid ixic acid , nitro furan d erivatives etc.) ; h aem o glo bino p ath ies
(sick le cell d isease, thalassaem ias); certain bacterial and viral infectio ns (H IV ).
– In tro p ical settings, the causes are o ften interlink ed , the two m o st co m m o n causes are
nutritio nal d eficiencies and m alaria. T he gro up s m o st at risk are child ren and y o ung
wo m en, p articularly d uring p regnancy .
– A naem ia in itself is no t an ind icatio n fo r transfusio n. M o st anaem ias are w ell
to lerated and can be co rrected with sim p le aetio lo gical treatm ent.
Clinical features
– C o m m o n signs o f anaem ia: p allo r o f the co njunctivae, m uco us m em branes, p alm s
of
h and s and so les o f feet; fatigue, d iz z iness, o ed em a in the lo wer lim bs, d y sp no ea,
tachy card ia, heart m urm ur.
– S igns th at anaem ia m ay be im m ed iately life th reatening: sw eating, th irst, co ld
extrem ities, tachy card ia, resp irato ry d istress and sho ck .
– L o o k fo r signs o f a sp ecific p ath o lo gy : ch eilo sis, nutritio nal d eficiency glo ssitis,
haem o ly tic jaund ice, signs o f m alaria (see p age 1 3 1 ) etc.
Laboratory
– H aem o glo bin level (o r if haem o glo bin is no t available, haem ato crit)
– T hick and thin blo o d film s o r rap id test if m alaria is susp ected
Normal values: > 13 g/dl in men; > 12 g/dl in women; > 11 g/dl in pregnant women; > 13.5 g/dl in newborns;
1
> 9.5 g/dl in infants from 2 to 6 months; > 11 g/dl in children from 6 months to 6 years; > 11.5 g/dl in children
from 6 to 12 years.
