-
World Journal of Gastroenterology Oct 2009Anemia and iron deficiency are so common in digestive diseases that often are underestimated and undertreated. Our goal is to review from classification to treatment of... (Review)
Review
Anemia and iron deficiency are so common in digestive diseases that often are underestimated and undertreated. Our goal is to review from classification to treatment of the diverse types of anemias in different digestive diseases to update our knowledge on diagnosis and treatment. With the goal of improving the prognosis and quality of life of digestive diseases patients, we will review current transfusion, intravenous iron, and erythropoietin roles in the treatment of anemia.
Topics: Anemia; Anemia, Iron-Deficiency; Blood Transfusion; Digestive System Diseases; Humans; Infusions, Intravenous; Iron
PubMed: 19787823
DOI: 10.3748/wjg.15.4615 -
Tidsskrift For Den Norske Laegeforening... Oct 2023While standard blood tests are often sufficient for an anaemia workup, sometimes more invasive diagnostic testing is required to exclude rare conditions.
BACKGROUND
While standard blood tests are often sufficient for an anaemia workup, sometimes more invasive diagnostic testing is required to exclude rare conditions.
CASE PRESENTATION
A man in his forties contacted his general practitioner because of increasing functional dyspnoea. He had completed a course of dicloxacillin a few months previously for a skin abscess on his abdomen. Bloodwork revealed severe anaemia (haemoglobin 5.4 g/dL), which required transfusion. Subsequent testing excluded iron and vitamin deficiency anaemia, haemolysis and malignancy. Initial bone marrow biopsy was of suboptimal quality. However, repeat tissue sample supported a diagnosis of pure red cell aplasia. The patient improved with ciclosporin treatment, which was gradually tapered.
INTERPRETATION
Pure red cell aplasia should be considered in patients with new onset isolated anaemia with severe reticulocytopenia. Diagnosis depends on obtaining representative tissue from bone marrow biopsy. It is difficult to conclude for this patient whether the aetiology of his pure red cell aplasia was idiopathic or secondary to recent dicloxacillin use.
Topics: Humans; Male; Anemia; Bone Marrow; Dicloxacillin; Neoplasms; Red-Cell Aplasia, Pure; Adult
PubMed: 37874056
DOI: 10.4045/tidsskr.23.0022 -
Acta Bio-medica : Atenei Parmensis Feb 2021Anemia can be the consequence of a single disease or an expression of external factors mainly nutritional deficiencies. Genetic issues are important in the primary care...
Anemia can be the consequence of a single disease or an expression of external factors mainly nutritional deficiencies. Genetic issues are important in the primary care of adolescents because a genetic diagnosis may not be made until adolescence when the teenager presents with the first signs or symptoms of the condition. This situation is relatively frequent for rare anemias (RA) an important, and relatively heterogeneous group of rare diseases (RD) where anemia is the first and most relevant clinical manifestation of the disease. RA are characterized by their low prevalence (< 1 per 10,000 individuals), and, in some cases, by their complex mechanism. For these reasons, RA are little known, even among health professionals, and patients tend to remain undiagnosed or misdiagnosed for long periods of time, making it impossible to know the prognosis of the disease or to carry out genetic counseling for future pregnancies. Since this situation is an important cause of anxiety for both adolescent patients and their families, the physician's knowledge of the natural history of a genetic disease will be the key factor for the anticipatory guidance for diagnosis and clinical follow-up. RA can be due to three primary causes: 1.Bone marrow erythropoietic defects, 2. Excessive destruction of mature red blood cells (hemolysis), and 3. Blood loss (bleeding). More than 80% of RAs are hereditary, and about 20% remain undiagnosed but when their first clinical manifestations appear during childhood or adolescence, they are frequently misdiagnosed with iron deficiency. For this reason, RA are today an important clinical and social health problem worldwide.
Topics: Adolescent; Anemia; Erythrocytes; Female; Hematologic Tests; Humans; Pregnancy; Prevalence; Rare Diseases
PubMed: 33682847
DOI: 10.23750/abm.v92i1.11345 -
British Journal of Anaesthesia Apr 2022Preoperative anaemia is common and associated with increased postoperative morbidity and mortality after cardiac surgery. These findings are supported by a large Dutch...
Preoperative anaemia is common and associated with increased postoperative morbidity and mortality after cardiac surgery. These findings are supported by a large Dutch cohort study including >35 000 patients published in this issue of the British Journal of Anaesthesia. Timely diagnosis and preoperative anaemia treatment seem to be reasonable targets for perioperative risk stratification and modification. However, implementation of anaemia therapy into clinical routines remains challenging, and evidence for improved outcome is currently limited.
Topics: Anemia; Cardiac Surgical Procedures; Cohort Studies; Humans; Preoperative Care; Treatment Outcome
PubMed: 35086686
DOI: 10.1016/j.bja.2021.12.049 -
Ugeskrift For Laeger Mar 2017Global migration has resulted in a larger geographical spread of people with risk of hereditary anaemias. This leads to an increased incidence of pregnant women with... (Review)
Review
Global migration has resulted in a larger geographical spread of people with risk of hereditary anaemias. This leads to an increased incidence of pregnant women with rare diseases, including thalassaemia also in Scandinavia. Thalassaemia can cause severe anaemia and other complications during pregnancy, like risk of miscarriage, intrauterine fetal death, abruptio, intrauterine growth retardation, hypertension, gestational diabetes and pre-eclampsia. In this article, we focus on the aetiology, assessment, antenatal care and treatment of pregnant women with thalassaemia.
Topics: Blood Transfusion; Chelation Therapy; Female; Humans; Iron Overload; Pregnancy; Pregnancy Complications, Hematologic; Thalassemia
PubMed: 28330551
DOI: No ID Found -
Transfusion Medicine (Oxford, England) Apr 2018Pre-operative anaemia and perioperative red blood cell transfusion carry significant consequence when it comes to surgical outcomes. The establishment of patient-centred... (Review)
Review
Pre-operative anaemia and perioperative red blood cell transfusion carry significant consequence when it comes to surgical outcomes. The establishment of patient-centred clinical pathways has been designed to harness and endorse good transfusion practice, termed the three pillars of patient blood management (PBM). These focus on the timely and appropriate management of anaemia, prevention of blood loss and restrictive transfusion where appropriate. This article reviews the current evidence and ongoing research in the field of PBM in surgery. Strategies to implement PBM have shown significant benefits in appropriate transfusion practice, reduced costs and improved length of hospital stay. Recently published national quality standards have recognised the features of the PBM blueprint such as the consideration of alternatives to red blood cell transfusion, the active measures to reduce perioperative blood loss and the appropriate management of post-operative anaemia. Adopting PBM in surgical patients should be paramount to reduce the risks posed by perioperative anaemia and blood transfusions. The principles of PBM help structure the interventions and decisions relating to anaemia and blood transfusion, but, more importantly, represent a paradigm shift towards a more considered approach to blood transfusion, acknowledging its risks, preventatives and alternatives.
Topics: Anemia; Blood Loss, Surgical; Blood Transfusion; Humans; Postoperative Complications
PubMed: 28940786
DOI: 10.1111/tme.12476 -
British Journal of Hospital Medicine... Feb 2023Anaemia is common before major surgery and increases complications. A new guideline aims to help with early diagnosis of the type and cause of anaemia and initiate...
Anaemia is common before major surgery and increases complications. A new guideline aims to help with early diagnosis of the type and cause of anaemia and initiate effective treatment. The guideline includes clear education for all staff and patients about the biology of iron homeostasis and patient blood management.
Topics: Humans; Anemia; Perioperative Care
PubMed: 36848164
DOI: 10.12968/hmed.2022.0552 -
Blood Sep 2020
Topics: Anemia, Diamond-Blackfan; Anemia, Hemolytic, Congenital; Humans
PubMed: 32702753
DOI: 10.1182/blood.2019004083 -
The Netherlands Journal of Medicine Jun 2011Anaemia is common in older individuals and, because of its association with various negative outcomes, adequate diagnosis and treatment is important. The present review... (Review)
Review
Anaemia is common in older individuals and, because of its association with various negative outcomes, adequate diagnosis and treatment is important. The present review focuses on prominent factors included in diagnostic and therapeutic algorithms for anaemia. Although pernicious anaemia is associated with severe vitamin B12 deficiency, evidence of an association between subnormal vitamin B12 and anaemia in older persons in the general population is limited and inconclusive. Accumulating evidence suggests that clinicians should at least reconsider the risks of a low vitamin B12 level before starting vitamin B12 supplementation in older individuals. Although clinicians may be reluctant to measure ferritin in older individuals due to its acute phase properties, such measurements are important in older persons with anaemia, especially in those with signs of inflammation. While a severe age-related decline in renal function may lead to a blunted erythropoietin response and anaemia, elevated erythropoietin levels are associated with increased mortality. More studies are needed to identify the clinical relevance and therapeutic implications of low and high erythropoietin levels in older persons. In contrast to other age-related diseases, telomere length is not associated with anaemia in older individuals in the general population. In conclusion, many issues regarding the aetiology of anaemia in old age remain unresolved. Because current guidelines on anaemia are based on the classic notions of the aetiology of anaemia, they may need to be revised for the highest age groups.
Topics: Age Factors; Aged; Aged, 80 and over; Anemia; Comorbidity; Humans; Sex Factors; Vitamin B 12 Deficiency
PubMed: 21868809
DOI: No ID Found -
American Journal of Medical Genetics.... Dec 2016Congenital anemias comprise a group of blood disorders characterized by a reduction in the number of peripherally circulating erythrocytes. Various genetic etiologies... (Review)
Review
Congenital anemias comprise a group of blood disorders characterized by a reduction in the number of peripherally circulating erythrocytes. Various genetic etiologies have been identified that affect diverse aspects of erythroid physiology and broadly fall into two main categories: impaired production or increased destruction of mature erythrocytes. Current therapies are largely focused on symptomatic treatment and are often based on transfusion of donor-derived erythrocytes and management of complications. Hematopoietic stem cell transplantation represents the only curative option currently available for the majority of congenital anemias. Recent advances in gene therapy and genome editing hold promise for the development of additional curative strategies for these blood disorders. The relative ease of access to the hematopoietic stem cell compartment, as well as the possibility of genetic manipulation ex vivo and subsequent transplantation in an autologous manner, make blood disorders among the most amenable to cellular therapies. Here we review cell-based and gene therapy approaches, and discuss the limitations and prospects of emerging avenues, including genome editing tools and the use of pluripotent stem cells, for the treatment of congenital forms of anemia. © 2016 Wiley Periodicals, Inc.
Topics: Anemia; Cell Transplantation; Gene Editing; Genetic Therapy; Hematopoietic Stem Cell Transplantation; Humans; Pluripotent Stem Cells
PubMed: 27792859
DOI: 10.1002/ajmg.c.31529