Hypochromic Case Studies

This type of anemia is described as small erythrocytes that contain small amounts of hemoglobin. Microcytic anemia can still occur if the cell is of normal size. There are a few things that may lead to microcytic-hypochromic anemia: an iron deficiency, a globin disorder, or a porphyrin and heme disorder. Having an iron deficiency is the most common cause of anemia. People that are at risk for iron deficiency are those who live in poverty, and especially those that are malnourished. Then there is sideroblastic anemia which is said to be inherited. Sideroblastic anemia arises when there is ringed sideroblasts in the bone marrow. A ringed sideroblasts is a cell that has iron granules wrapped around its nucleus. Since the iron is wrapped around the nucleus, it is not being synthesized into hemoglobin. Sideroblastic anemia results in an increase of iron in the

Iron Deficiency Anemia affects millions of individuals across the world. This disease strikes many more women than men and has harmful effects on all who suffer from this deficiency that causes oxygen-carrying capacity to decrease. The causes can vary amongst different groups, but the aggravating symptoms remain constant. Much of the research on Iron Deficiency Anemia concentrates on not only the treatment of this disease, but also the prevention of it. To attain a better understanding of how to treat this problem, one must clearly know what Iron Deficiency Anemia means, what causes this disease, the effects of it, and finally how to cure it.

As a provider, one will care for many patients that have different types of anemia. Anemia is not so much as a disease as a symptom of an underlying issue. Although there can be particular signs and symptoms associated with anemia, the basis of a diagnosis is from laboratory data. For the purpose of this discussion, I will evaluate a case study and give a differential diagnosis. I will also assess how patient history, physical exam, and lab reports support my diagnosis. I will explain the pathophysiology of the type of anemia and give causes and treatment options available.

Hemochromatosis, also called iron overload, is a disease when the body absorbs too much iron from the food we eat and most often affects the liver, heart, pancreas, and skin. It is usually caused by genes in the body that mutate keeping them from working. Some signs and symptoms of this disease are weakness, joint pain, low libido, and/or if the disease has progressed to far diabetes or heart failure. Hemochromatosis is one of the more difficult diseases to diagnose because many symptoms are nonspecific and usually many people don’t show as many symptoms except elevated iron levels in their blood. Most will be treated with blood transfusions until the normal level of iron is reached. If diagnosed early the prognosis is excellent with possible checkups or phlebotomies.

Iron deficiency anemia, one of the most common types of anemia, is a blood disorder where

Also known as normocytic anemia. This is the most frequent type of anemia most often happening to males over 85 years old. It is a common problem that occurs to men and women over 85 years old. Symptoms include and are caused by: a reduced production of normal-sized red blood cells even though presence of hemoglobin in the red blood cells is within the standard range; an increased production of HbS as is seen in sickle cell diseases; greater destruction and loss of red blood cells; an increase in plasma volume that is not compensated by anything else; a B2 (riboflavin) deficiency; and a B6 (pyridoxine) deficiency. (Brill & Baumgardner 2000).

* Anemia-related fatigue occurs when there is a decrease in red blood cells (RBCs). This happens when myeloma cells replace RBCs in the bone marrow.

Methemoglobinemia is a hemoglobinopathy where the concentration of methemoglobin in the blood is more than 1% of the total hemoglobin [3]. Normal hemoglobin has a reduced ferrous iron (Fe 2+) while methemoglobin has an oxidized ferric iron (Fe 3+). The change in valence prevents methemoglobin from being able to carry oxygen [4, 9]. There are mechanisms in place to reduce the amount of methemoglobin in the blood [2]. Cytochrome b5-Methemoglobin reductase and nicotinamide adenine dinucleotide phosphate (NADPH) methemoglobin reductase enzymes are responsible for reducing the amount of methemoglobin in the blood [9].

Anemia is a condition that effects “more than 3 million people in the United States” (Peterson, 2012). Anemia is a decrease in red blood cells (RBCs) or decreased hemoglobin in an individual’s blood. RBCs carry oxygen rich blood throughout an individual’s tissues and organs, allowing the body to function properly. Therefore, an anemic person has a decreased amount of oxygen rich blood flowing through their body. A decreased amount of oxygenated blood is not immediately life threatening but can become very serious. Some potential side effects of anemia are; fatigue, lack of energy, pallor, organ damage, heart failure and death (Peterson, 2012). There are multiple types of anemia with the most common being; iron-deficiency anemia, folic acid-deficiency anemia, vitamin B12 deficiency and microcytic anemia (PDRhealth, 2015).

Conferring to the case study 1 of Ms. A, who is suffering from iron deficiency anemia. “People who experience iron deficiency anemia lack adequate iron required to produce hemoglobin. Hemoglobin supports red blood cells in carrying oxygen all through the body” (Mayo Clinic, 2014). In this presentation, the writer will provide rationales where Ms. A is presenting signs and symptoms of Iron Deficiency Anemia.

Ms. A is 26-year-old female with a history of menorrhagia and dysmenorrhea since she was 14-16 years old. In addition, she has taken aspirin during menstruation and for preventing and alleviating joint pain during golf season. Her signs and symptoms include shortness of breath, lethargy, light headache, tachycardia, tachypnea, and hypotension. Her laboratory values show low Hemoglobin (HB), Hematocrit (HCT) and Erythrocyte (RBC) but normal in Reticulocyte (REIC) count. According to Chen, Zieve, & Ogilvie (2014, p. 1), the normal value of HB is 12.1 to 15.1g/dl, HCT is 36.1% to 44.3%, RBC count is 4.2 to 5.2 x10/mm and RETIC count is 0.5% to 1.5% in female. The low Hemoglobin and Hematocrit can direct that Ms. A has anemia. The RBC smear can determine her classification of anemia. Her RBC smear showed microcytic and hypochromic cells. The evidence can indicate that Ms. A has Iron Deficiency Anemia (IDA).

Presumed to have been plaguing humanity since the Viking days, hemochromatosis is a fatal hereditary disease that upsets the body's natural metabolizing of iron. The mineral, although essential to the survival of all living organisms, becomes extremely lethal in abnormally large quantities. Unfortunately, this serves as rather tragic news to the afflicted, since their bodies absorb iron in an uncontrollable manner. A wide variety of medical complications and symptoms, including cancer, infertility, psychiatric disorders, diabetes, arthritis, damage in the overall body chemistry and joints, could consequently occur over a long period of diagnosis. Major organs such as the heart and liver additionally suffer at the hands of hemochromatosis, further adding to the possibility of death if the disease remains unchecked.

The body has no way of ridding itself of the extra iron. Over time the extra iron accumulates in vital organ such as the liver, joints, heart, pancreas and the pituitary resulting in disease. For this reason, individuals with hemochromatosis must take steps to reduce the level of body iron and one of these steps is, dietary modifications. And treatment to the complications of hereditary haemochromatosis.

also had a complete blood count, a blood test, as a baseline to assess his overall health. The complete blood count is “To evaluate numerous conditions involving red blood cells, white blood cells, and platelets. This test is also used to indicate inflammation, infection, and response to chemotherapy (Bladh et al., 2013).” T.A.’s abnormal blood results were as follows: RBC 3.3 10^6 cells/microL (low), hemoglobin 11.0 g/dL (low), hematocrit 33.2% (low), and mean corpuscular volume 99.7 fL (high). The normal range for RBC should be 3.8-5.81 10^6 cells/microL. Hemoglobin and hematocrit levels should be 12.6-17.4 g/dL and 36-52%. Normal mean corpuscular volume should be 79-103 fL. T.A.’s abnormal lab values indicate anemia. A decrease in red blood cell is related to nutrient deficiency such as a deficiency in iron or vitamins that are needed for red blood cell production and maturation. The decrease production or maturation of red blood cells lead to anemia in the patient. A low hemoglobin is associated with an overall decrease of red blood cell count and anemia caused by nutritional deficit of iron, vitamins, and folate. It can also be low due to a decrease level of erythropoietin caused by the AKI. Like hemoglobin, a low hematocrit is associated with an overall decrease of red blood cell count due to anemia, nutrition deficiency, and AKI. T.A.’s increased mean corpuscular volume is related to anemia caused by vitamin B12 or folate deficiency (Bladh et al.,

Ms. A. has iron deficiency anemia (IDA) a form of microcytic anemia, which is characterized by small erythrocytes with reduced amounts of hemoglobin. IDA is the most common type of anemia in the world. In the United States (US) females of childbearing age have a higher incidence than