Anemia Key Points

• Anemia is a reduced RBC mass, resulting in decreased oxygen-carrying capacity of the blood (>2 SD from mean for age, gender, and race).

• Patients with unrecognized anemia often present with symptoms of fatigue, loss of stamina, shortness of breath, and tachycardia (with exercise).

• Acute blood loss or anemia is almost always caused by hemorrhage or hemolysis.

• Loss of 30% of blood volume results in postural symptoms; loss of 40% blood volume produces signs of shock.

• Bone marrow responsiveness to anemia is best evaluated by reticulocyte index and marrow production index.

• Anemias can be best understood by classifying them into three types: hypoproliferative anemia, maturation disorders, and hemolytic-hemorrhagic anemia.

• Anemia of chronic disease is a hypoproliferative anemia now referred to as the anemia of inflammation (AI).

• Serum ferritin is normal or increased in AI and low in true iron deficiency

• Treatment of folate deficiency with alcoholic neuropathy without confirming vitamin B12 deficiency may result in a progressively worsening neuropathy.

• Values below lower limits of normal for age/gender indicate only 25% likelihood that the person is not anemic.

• If creatinine is greater than 2 mg/dL and no other cause for anemia can be found, the anemia probably results from renal inefficiency.

• Bilirubin gallstones occur in 40% to 60% of sickle cell disease patients.

• The absence of free haptoglobin is diagnostic of hemolytic anemia.

• Sickle cell disease is a form of hemolytic anemia; thrombosis is more common in children, whereas hemorrhage occurs more often in adults with sickle cell disease.

• Coombs test is the diagnostic choice for autoimmune hemolytic anemia.

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Soccer Fitness 101

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