Anemia: Clinical

Anaemia is a frequent occurrence in children who come for adoption, in individuals who have travelled extensively in the tropics and in people from third-world countries. A problem that occurs during or after a trip does not necessarily need to have a causal connection with that trip.

The symptoms are often vague and non-specific: fatigue, dyspnoea, palpitations, tachycardia. Pale mucosae will be encountered in severe anaemia. The nailbed will be pale and with prolonged iron deficiency the nails can become brittle and flat or even hollow (koilonychia). A haematocrit and haemoglobin determination is more reliable than physical examination. It should always be determined whether a microcytic, normocytic or a macrocytic anaemia is involved. Equally it is essential to know reticulocyte numbers to distinguish between anaemias due to excessive blood loss/haemolysis and those due to reduced production. Analysis of the blood shows whether an isolated anaemia is involved, or whether it is part of for example a pancytopenia (e.g. in hypersplenism, in bone marrow infiltration or bone marrow aplasia)

Category: Pathology Notes