Anemia of the 1st degree is the most mild manifestation a whole complex of diseases that are characterized by a decrease in hemoglobin concentration or the number of red blood cells. As a result of anemia, many changes begin in the body, which are caused by insufficient oxygen supply to organs and tissues. Manifestations and pathological changes in the body directly depend on the severity of the disease.
Classification
The classification of anemia is quite simple. They are distinguished depending on the causes of occurrence into the following types:
- Posthemorrhagic anemia, which develops as a result of a decrease in the amount shaped elements blood, red blood cells, as a result of acute or chronic blood loss. Their causes may be trauma, severe or frequent births, heavy menstruation, stomach ulcer. In infants posthemorrhagic anemia most often develops as a result of birth trauma, internal hemorrhages, placental bleeding, and hemorrhagic diathesis.
- Hemolytic anemia occurs as a result of the pathological breakdown of red blood cells. This form of the disease is quite rare and occurs under the influence of various autoimmune and hereditary factors.
- Deficiency anemia caused by impaired erythropoiesis. This group of anemias is the most common. This includes iron deficiency anemia, which occurs in the vast majority of cases, megaloblastic anemia, caused by a lack of vitamin or folic acid. Sometimes so-called multifactorial anemia develops, caused by a simultaneous deficiency of iron and B12.
- Hypoplastic and aplastic anemia resulting from dysfunction of the bone marrow. This variety is extremely rare. It is either hereditary in nature or develops after severe chronic diseases, the action medicines, chemical substances.
In addition, for the purpose correct scheme treatment requires determination of the degree of anemia by hemoglobin. This is calculated based on the deviation of the hemoglobin value from the norm. Hemoglobin is the main iron-containing coloring element of red blood cells, which is “responsible” for the transport of oxygen with blood throughout the body.
For an adult man, the hemoglobin concentration is 135 – 160 g/l. For women, this value is slightly lower and ranges from 120 to 140 g/l. For children, the normal hemoglobin level depends on age. These values are shown in the table:
Age
For teenagers aged 16 and over, adult standards apply.
Causes
Most of the iron contained in the body is found in red blood cells; there are also reserves of this substance in the muscles, liver and bone marrow. Daily requirement for an adult, the iron content is about 10–15 mg. Of this amount, no more than 1.5 mg is absorbed into the blood; approximately the same amount is normal daily physiological losses through sweat, urine and feces. As for children, then daily need infant in iron is 0.5 - 1.2 mg, this figure increases with age, and a two-year-old child needs about 10 mg of iron per day.
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Torsunov O.G. About the causes of iron deficiency anemia
The causes of iron deficiency anemia are most often not too abundant, but chronic blood loss for hemorrhoidal bleeding, acute course peptic ulcer, heavy menstruation and other similar conditions. Iron in development deficiency anemia also plays a role in insufficient intake of iron from food or a violation of its absorption after suffering surgical intervention on the stomach.
Iron deficiency anemia often develops in premature babies, since many substances necessary for normal hematopoiesis are formed in the last two months of pregnancy. The cause of this disease in infants may also be iron deficiency anemia. varying degrees severity in a woman during pregnancy.
B12 - deficiency anemia develops due to insufficient intake of this vitamin from food, since it is not synthesized in the body. B12 is absorbed in the gastrointestinal tract with the help of a special enzyme called gastromucoprotein (also called Castle factor). After gastrectomy, with gastritis, chronic alcohol consumption, the secretion of Castle factor sharply decreases and, as a result, B12 deficiency develops.
There are certain reserves of folic acid in our body. It also comes with food and is absorbed into the duodenum and ileum. This process can be disrupted under the influence of alcohol, long-term use hormonal contraceptives, anticonvulsants, some antibacterial drugs, in particular trimethoprim or sulfomethoxazole.
Clinical manifestations
Symptoms largely depend on the severity of the disease. Moreover, with each subsequent stage, existing symptoms worsen and new ones may appear.
- First degree anemia is practically asymptomatic. Sometimes a person complains of slight weakness, malaise, and fatigue. Noticeable pallor appears skin, sweating, loss of appetite. Anemia mild degree in infants it is characterized by increased excitability of the child, tearfulness, excessive regurgitation after feeding (or vomiting in older children).
- Anemia medium degree severity is manifested by headaches, dizziness associated with insufficient oxygen supply. Children with this form of anemia get tired very quickly and have difficulty withstanding even the lightest physical activity. A child under one year old may even experience regression in the development of motor skills. There is roughness or dryness of the skin, very painful cracks in the corners of the mouth, and digestive disorders may occur, which manifest themselves in the form of diarrhea or constipation, and flatulence. From the cardiovascular system, tachycardia and heart murmurs may be observed.
- Anemia of the 3rd degree is characterized by changes in the structure of nails and hair (they acquire a matte tint and become very brittle), hair loss, a feeling of coldness and numbness in the extremities, and a distorted perception of smells and tastes. Stomatitis and caries (even tooth decay) may appear. Children may be behind in physical and psychological development. On ultrasound of organs abdominal cavity noticeable enlargement of the liver and spleen. With absence adequate treatment Severe anemia is dangerous and can cause extremely serious consequences.
The severity of symptoms may vary depending on general condition a child or adult suffering from anemia. Also, the likelihood of the occurrence of a particular clinical sign depends on the cause of the disease.
Diagnostics
You can assume the development of this disease in yourself or in a child by simply clinical analysis blood, which can be donated without a doctor’s referral in any laboratory. If the hemoglobin concentration decreases below normal, you should mandatory consult a therapist or pediatrician.
Then a biochemical blood test is prescribed. There is a decrease in the number serum iron, ferritin level (a protein that helps maintain iron reserves), transferrin saturation with iron.
Naturally, the doctor pays attention to general symptoms anemia and conducts comprehensive examination to determine what changes this disease has caused in the body.
Treatment of first degree anemia
Anemia of the 1st degree in children and adults is usually very mild and in most cases does not require medical correction. It is enough to make certain changes in your diet and daily routine. Long walks are recommended fresh air, moderate physical activity.
If grade 1 anemia is detected, then the diet for children and adults should be formulated taking into account the following principles:
- Increase your protein intake. To do this you need to eat eggs, dairy products, liver, kidneys, fish and meat.
- Limit milk and strong tea, since these drinks slow down the absorption of iron from gastrointestinal tract. Preservatives, oxalates, phosphates and some medications, for example, antacids and tetracycline antibiotics, have the same effect.
- Instead of animal fats, it is necessary to give preference to vegetable ones. Must be consumed butter, season salads with a variety of vegetable oils(sunflower, olive, grape and the like).
- If there is no acute problem with overweight, then the amount of carbohydrates in the diet can not be limited.
- Vitamins C and group B contribute to better absorption of iron. Therefore, it is advisable to introduce products that contain them into the menu. These are citrus fruits, greens, legumes, many berries, etc.
- Consumption of iron-containing foods ( beef liver, rabbit and turkey meat, buckwheat and oatmeal, millet, caviar).
It is worth noting that it is imperative to monitor blood dynamics and control hemoglobin levels. In most cases, with proper adherence to the diet, its value increases to normal numbers, and further prescription of medications is not required.
Treatment of anemia of 2 and 3 degrees
Treatment of anemia of moderate degree or more severe form consists of prescribing special medications depending on the cause of the disease. Thus, iron deficiency anemia requires long-term treatment iron supplements in a dosage of 100–120 mg per day. It is worth noting that medication must be continued after the patient’s condition has normalized and hemoglobin levels have been restored. This is due to the fact that in addition to eliminating the deficiency state, it is necessary to replenish iron reserves in the body. In most cases, for the convenience of the patient, medications are prescribed in tablets. Parenteral administration indicated when the absorption of this element in the digestive tract is impaired.
Treatment of B12 deficiency anemia is carried out using injections of cyanocobalamin or hydroxocobalamin at a dosage of 400 - 500 mcg per day for the first week. Then they switch to maintenance therapy, during which the same injection is given once every 7 days. The total duration of therapy is about two months. If the cause of such anemia cannot be eliminated, then it is necessary to give preventive injections of cyanocobalamin several times a year to maintain normal B12 levels.
Treatment of grades 2 and 3 folate deficiency anemia is the same. Prescribed 5 mg of folic acid three times a day.
Treatment of rarer forms of anemia is much more difficult. At hemolytic anemia a long course of prednisolone is indicated. Aplastic anemia was previously considered incurable and often resulted in death. On this moment This disease is treated with a bone marrow transplant.
Features of the treatment of anemia in children
Anemia treatment should be carried out under the strict supervision of a physician. If infants are on artificial feeding, then special mixtures with increased content gland. It is recommended that a child with iron deficiency anemia introduce complementary foods several weeks earlier and start with applesauce and oatmeal and buckwheat porridge.
Anemia of the 2nd degree in children cannot be treated with simple nutritional correction. The use of drugs that contain ferric iron is required. These are maltofer, ferrum lek, ferlatum, etc. For this form of the disease, they are given in the form of drops or syrup. Parenteral administration of drugs is indicated for third degree anemia. In parallel with these medications, multivitamin complexes are also prescribed, because this disease is accompanied by vitamin deficiency.
When severe anemia develops in infants, recombinant human erythropoietin is also prescribed. These are drugs such as Recormon, Eprex, Epocrine. The same drugs are also prescribed to premature babies born at 4–5 weeks. ahead of schedule. Typically, the dosage of such drugs is 250 IU per kg of body weight three times a week, but what younger age child, the larger the dose required for effective treatment.
Besides drug therapy, long walks are recommended, strict regime day, eliminating psychological stress. The effect of treating anemia in children is noticeable already on the seventh day. If there is no effect after two weeks of therapy, then a re-examination is carried out or the dose of medication is adjusted.
In general, the most common types of deficiency anemia are easily treatable, even at the most severe stage of the course. However, medication can be avoided if proper diet nutrition and active lifestyle.
Hematologist
Higher education:
Hematologist
Samara State medical University(SamSMU, KMI)
Level of education - Specialist
1993-1999
Additional education:
"Hematology"
Russian Medical Academy Postgraduate Education
Anemia is a syndrome characterized by low levels (compared to normal levels) of hemoglobin. Hemoglobin is a protein that contains an iron atom. Iron, in turn, is found only in red blood cells. Without these cells, the protein's condition begins to rapidly deteriorate. Normal hemoglobin level for healthy person- from 110 to 155 grams per liter. If your hemoglobin level drops and reaches below 110, then you have first-degree anemia. Men's hemoglobin levels should be slightly higher than women's. An indicator from 110 to 120 for men is considered maximum acceptable norm, although abnormal for the full functioning of the male body.
How to determine first degree anemia?
Anemia of the 1st degree is quite difficult to detect without blood tests. A person may appear to be quite healthy because the body can, within certain limits, compensate for the decrease in red blood cell mass. You need to be careful and not rush to blindly apply this practical definition anemia in every case. There are times when there is rapid bleeding and red cells and plasma are quickly lost at the same time before the body can respond to hiking before replenishing plasma volume with blood substitutes.
First degree of anemia
All types of anemia can be divided into several groups. Data for assessing the degree of order are classified in ascending order. Anemia of the 1st degree is characterized by a hemoglobin level of 110 to 90. In turn, hemoglobin, when it ranges from 110 to 90, may not manifest itself in Everyday life. The blood level appears only during any physical stress.
Is it worth treating first degree anemia?
You should not wait until anemia develops from the first stage of the disease to the second or third. Anemia of the first degree, which develops over a sufficiently long period of time, incurs a significantly greater loss of red blood cell mass before its symptoms are detected. This is terrible, but it is not uncommon for hematologists to see a patient with a hemoglobin of 4 g/dL. And this, think about it, leads to the loss of 70% of the red blood cell mass. Often relatives are concerned that their family member looks a little blurry and tired. And the results of the examination are simply shocking!
Symptoms of first degree anemia
When the symptoms of first degree anemia develop, they begin to manifest themselves to a large extent given the precarious state of oxygen delivery to the tissues. You may experience the following warning signs:
- Dyspnea (shortness of breath) during physical activity;
- Fast fatiguability;
- Fainting;
- Dizziness;
- Headache.
Besides, the cardiovascular system can produce palpitations and tinnitus. Pre-existing cardiovascular pathological conditions are also aggravated by anemia. Angina pectoris, intermittent claudication and night cramps indicate the influence of anemia.
Clinical signs develop more slowly. The patient has pale skin, tachycardia and systolic murmur. In rapidly developing anemia (with hemorrhage in some cases with catastrophic hemolytic anemia),
Additional symptoms and signs to note:
- Fainting when getting out of bed,
- Orthostatic hypotension ( blood pressure falls when the patient rises from a lying position to a sitting or standing position),
- Orthostatic tachycardia.
Your rating of these clinical signs will serve you better in diagnosing this type of anemia than a laboratory.
Classification
First degree anemias can be classified according to schemes. This depends on the following factors:
- Cell size and hemoglobin content parameters such as ESR and MSHC;
- Erythrokinetic schemes (those that take into account the rates of red blood cell production and their destruction);
- Biochemical/molecular frameworks (those that consider the etiologies of anemia at the molecular level).
With normochromic, normocytic anemia, normal MSHC and normal ESR are maintained.
These include:
- Anemia of chronic diseases;
- Hemolytic anemia (characterized by accelerated destruction of RBC);
- Anemia from acute blood loss;
- Aplastic anemia (characterized by the disappearance of RBC from the bone marrow).
With hypochromic, microcytic anemia, it can be traced low level MSNS, low ESR.
These include:
- Iron-deficiency anemia;
- Thalassemia;
- Anemia chronic disease(in rare cases).
Normochromic, macrocytic anemia (normal MSHC, high ESR).
These include:
- Vitamin B12 deficiency;
- Folate deficiency.
How to treat first degree anemia?
Disruption of the hematopoiesis process in the body is fraught with serious consequences. But at home, fortunately, it can be restored normal work body is possible. Listed below best methods recommended treatment.
Many people diagnosed with first-degree anemia acquire a juicer. This electrical appliance is simply indispensable for the daily preparation of freshly squeezed juices from fruits and vegetables. The fact is that beet, carrot and apple juices promote hematopoiesis. You can make mixed fruit and vegetable juices and add honey to them.
Freshly squeezed beet juice should not be drunk immediately. Let it sit for at least two hours in the refrigerator. The harmful fumes inherent in beets should “evaporate” during this period, so do not cover the lid of the jar in which you will store beet juice too tightly. Beet juice should be taken between meals or half an hour before meals. Other fruit and vegetable juices should also be taken before meals, 2-3 times a day, two tablespoons.
Yarrow
Pour boiling water over the yarrow herb and let it sit in a thermos for an hour. Then you can take a couple of tablespoons three times every day.
Vitamin “cocktail”
Buy 100 grams of dried fruits: prunes, raisins, dates, figs. Grind the mixture through a meat grinder and add lemon. Add 2-3 tablespoons of honey to the mixture and place in the refrigerator. The mixture should be consumed 2 spoons 2-3 times a day between meals. Dried fruits will saturate your body useful microelements and will eliminate the manifestations of anemia.
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Anemia is a common disease, affecting a quarter of the population. Symptoms depend on the stage, the mildest is grade 1 anemia, what it is, how to deal with it, a specialist will tell you after a detailed study of the tests and the general condition of the patient.
How and why severity is calculated
It is quite difficult to independently determine the presence of pathology; for this you need to undergo diagnostic test. The reason for contacting medical institution may become quickly fatigued, constant fatigue after light physical activity. To make a diagnosis, you should take a general and biochemical tests blood, undergo a myelogram. These tests will help establish the disease and determine the degree of anemia, since the complex of treatment will depend on these indicators.
The following data is taken into account:
- hemoglobin level (including the amount in individual red blood cells);
- color index;
- serum iron level;
- change in the shape and size of red blood cells.
Anemia and its severity in terms of hemoglobin level entails a deterioration in the state of protein in the blood. The norm for an adult is 100-155 g/l; a decrease in this indicator to the lower limit or more is a sign of the disease.
How often do you get your blood tested?
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Only by prescription of the attending physician 31%, 1742 vote
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I take care of my health and donate once a month 6%, 341 voice
I'm afraid of this procedure and try not to pass 4%, 237 votes
21.10.2019
The causes of the first, second or third degree of severity of anemia are:
- large blood loss;
- malnutrition;
- changes in bowel function that interfere with iron absorption;
- period of pregnancy and lactation (increased need for iron).
But the development of anemia is characteristic not only with a decrease in hemoglobin in the blood. There are varieties that have both similarities and differences:
- B12 deficiency and folate deficiency. Due to the lack of these substances, slight itching appears in the area of the upper and lower limbs, inflammation and burning of the tongue, the skin becomes yellowish, appetite decreases, and the person becomes irritated.
- Iron deficiency. More often unpleasant symptoms occur after physical exertion. These are fatigue, shortness of breath, slight tachycardia, pale skin, increased fragility of nails, hair, etc.
- Aplastic. Appears against the background of an insufficient number of red blood cells in the bone marrow, therefore characteristic symptoms are frequent dizziness, general malaise, lack of air, rapid heartbeat, tinnitus, etc. With this disease, bruises easily remain on the skin, and the risk of nosebleeds and bleeding gums increases.
- Hemolytic. Due to hereditary pathologies, there is increased destruction of red blood cells, which leads to weakness, tachycardia, and mild pain in the left hypochondrium.
- Posthemorrhagic. Occurs after major blood loss. Chronic form may be a consequence of slight bleeding due to a stomach ulcer or during menstruation, as a result of which it turns into iron deficiency. Accompanied by decreased performance, weakness, and shortness of breath.
First mild degree
Mild anemia is quite difficult to determine visually, since the person looks healthy at first glance. Testing is required to make a diagnosis. The hemoglobin level is 90-110 g/l, and this indicator is often typical only due to physical activity.
Anemia is a syndrome characterized by low performance level (compared to the norm) of blood hemoglobin, and not only general meaning, but its quantity in one red blood cell.
Hemoglobin function and its norms
Hemoglobin is a protein containing an iron atom that can bind oxygen molecules. It is found only in red blood cells. Outside these cells, this protein is quickly destroyed. Normal indicators the range is considered to be from 110 to 155 g per liter (for women - 110-145, and for men - 120-155). A drop below 110 is anemia. The fact is that hemoglobin from 110 to 120 in men is considered the maximum permissible, although abnormal.
Degrees of anemia
Causes and forms of the disease
The causes leading to the development of the disease determine its forms.
1. Acute anemia. They are always associated with quick loss red blood cells There are two reasons for this: bleeding and rapid destruction of red blood cells. The latter circumstance is observed, for example, in case of poisoning Rapid decline hemoglobin level exceeds the rate of development of the body's compensatory capabilities. Therefore, grade 1 anemia can occur even at rest.
2. Chronic anemia accounts for more than 80-85% of all diseases of this type, so their causes are the most common. This is a whole range of diseases, for example, deficiency of any factor at any stage of hemoglobin synthesis, pathology of the structure of erythrocytes and their diseases. Deficiency factors include lack of iron, cyanocobalamine, cytochromes, and porphyrin. Red blood cell pathology can be congenital or acquired. In the first case, red blood cells are either formed with defects that lead to a decrease in the level of hemoglobin in them, or they themselves are very unstable and prone to rapid destruction. Often the first signs appear even when a person has grade 1 anemia. Acquired pathology occurs as a result various diseases leading to early destruction of red blood cells. An example of this is malaria.
Clinical manifestations of chronic anemia
Regardless of hemoglobin level chronic anemia, the severity of which is determined only by the severity of manifestations, has a certain set of symptoms.
· Dizziness, tinnitus and flashing “spots” before the eyes.
· Pale skin.
· Brittle nails, changes in their shape and color.
· Dry skin and hair loss.
All these signs are not necessary for one person. Thus, degree 1 anemia in some may manifest itself only as pallor and dry skin, while others may experience brittle nails and hair loss under normal conditions.
Prevalence of anemia among surgical diseases
The problem of anemia is not only therapeutic; a small percentage of its cases occurs in surgical practice. And often anemia is the first sign of any pathology that requires emergency surgical intervention. One of the common such conditions is bleeding from the organs of the digestive tube.
Carrying a child is often accompanied by negative changes in the female body. More often they are characteristic of those expectant mothers who had low immunity before pregnancy. Indeed, in the first trimester of bearing a child there is a tendency to weaken it even more. One of the signs of this is. How is this pathology characterized? What should expectant mothers know about its effect on the fetus and treatment? Let's look into the issue.
Why does anemia develop?
When is birth in the uterus new life, the body of the expectant mother rearranges its work. Now it functions with double load, supplying the fetus nutrients, oxygen, protecting it. The increased load on all organs and systems is the main reason for the decrease in protective forces female body. As a result of this, various complications arise, including anemia, which is characterized by a decrease in the level of red blood cells (erythrocytes) in the blood. Pathology occurs because the fetus actively “takes” iron from the mother, without which the formation of red blood cells is impossible.
An obstetrician-gynecologist makes a diagnosis of “iron deficiency anemia” to his patient if her level is below the normal level of 110 g/l. The first degree of anemia is characterized by a hemoglobin level of 90-110 g/l; second - 70-90 g/l; third - below 70 g/l. If, according to the results of a blood test, the level of red blood cells is below 40 g/l, then they speak of severe iron deficiency anemia. But this condition is not typical for pregnant women, because with low hemoglobin it is sometimes impossible to conceive a child.
During the period of fetal formation, its active growth and iron consumption, there is often a need to replenish the substance in the mother’s body with food. When this does not happen, iron deficiency anemia occurs. Most often this is her first degree. This pathology is more typical for women who have genetic predisposition to her appearance. The condition also occurs in expectant mothers with chronic or infectious diseases internal organs, in those who have given birth repeatedly, those carrying twins, or those suffering from toxicosis during pregnancy. First degree anemia may be characteristic of women with heavy menstruation before pregnancy; minors; who have overcome the thirty-year mark; having bad habits.
Symptoms of first degree anemia
It is worth noting that iron deficiency anemia is diagnosed based on the results general analysis blood. At the beginning of pregnancy it appears fatigue, increased irritability, drowsiness, low performance. The woman complains of exhaustion, weakness in the body, dizziness, tinnitus, and the appearance of “spots” before the eyes. For minor physical activity, for example, climbing stairs, future mom experiences rapid heartbeat and shortness of breath. Sometimes symptoms of first degree anemia include dryness and flaking of the skin, splitting of nails, loss of hairline on the head.
Treatment of anemia
Most often, obstetricians-gynecologists prescribe medicines with iron content. These are Tardiferon, Sorbifer, Ferroplex, Aktiferin, as well as vitamin B12 (cobalamin) in injections. The dosage of drugs and the regimen are determined individually, based on the general condition of the expectant mother. Doctors emphasize that the tablet forms of the above drugs should be washed down with juices, because the latter are rich ascorbic acid, promoting the absorption of iron.
What is the danger of first degree anemia?
It is worth noting that initial form pathologies today respond well to treatment. It is enough to follow the doctor’s instructions, adjust the diet - and in a week the expectant mother will feel much better.
And if iron deficiency anemia is not given importance, then its first degree will develop into the second and can complicate the course of pregnancy. The baby will not receive sufficient quantity useful substances, will begin to suffer from hypoxia ( oxygen starvation), which is fraught with placental abruption, premature onset of labor, and bleeding. Normal level hemoglobin in the blood of a pregnant woman is the basis for healthy pregnancy.
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