Sanisera Fieldschool, session no. 5, 2010: Anemia, Porotic Hyperostosis and Cribra Orbitalia, by Teddy DePalo
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Sanisera Fieldschool, session no. 5, 2010: Anemia, Porotic Hyperostosis and Cribra Orbitalia, by Teddy DePalo
- 1. Anemia, Porotic Hyperostosis and CribraOrbitalia Etiology and Prevalence in the Roman Empire Teddy DePalo Ecomuseu Cap De Cavalleria - Menorca Session #5
- 2. Iron Deficiency Anemia Anemia is the most common blood disorder and is caused by a decrease of the number of either red blood cells or hemoglobin present in the blood. Iron deficiency anemia occurs when the dietary intake of iron is insufficient and the hemoglobin, which contains iron, cannot be formed.
- 3. Causes of Sideropenic (Iron Deficiency) Anemia Malnutrition Women of Childbearing Age Children with Low Birth Weight Blood Loss, Excessive Hemorrhaging Chronic Diarrhea Genetic Parasitic Infection
- 4. Porotic Hyperostosis and CribraOrbitalia Porotic Hyperostosis is a disease that manifests with porosities in the cranial vault that causes the bone tissue to appear spongyand soft. Cribraorbitalia is a bone condition also characterized by porotic lesions in the bony orbital roof of the frontal bone. Since the 1950s, chronic iron-deficiency anemia has been universally regarded as the probable cause of both of these conditions.
- 6. What can they tell us? Since these conditions are mainly from non-genetic factors we can therefore use the information to reconstruct the lifestyles of past civilizations. In addition, these lesions can appear from childhood marking periods of infant anemia and reveal the habits of a person throughout his or her lifetime.
- 7. Case Study: Imperial Rome and the Early Middle Ages The widespread find of these conditions in two skeletal samples from Latium (central Italy) was used to access the health and life conditions of people in Italy after the collapse of the Roman Empire. Roman Imperial Age (1st-3rd centuries A.D.) rural town of LucusFeroniae 7th century A.D. Lombard necropolis of Selvicciola
- 8. Findings of the Study Examined 93 individuals in LucusFeroniae and 53 in Selviccola Discovered a far higher incidence of these conditions in infancy at around 75% of the individuals which decreases to about 30% by age 30 and 15% by 50 Dental disease and dental enamel hypoplasia was also discovered
- 9. Thanks for Listening! Any Questions?
Editor's Notes
- This is important because the hemoglobin which resides in the red blood cells are responsible for the transport of oxygen through the body.So, when the body has sufficient iron to meet its needs (functional iron), the remainder is stored for later use in the bone marrow, liver, and spleen.Iron deficiency can range from iron depletion, which yields little physiological damage, to iron deficiency anemia, which can effect the function of numerous organ system and can leave clear physical damage.
- People with poor diets or who are under nourished often suffer from iron deficiency. For example, people who eat more meat ingest iron more efficiently since meat doesn’t need processing and they also ingest amino acids from the meat proteins that enhances iron absorption. Conversely, plants have poor absorption rates and some even inhibit absorption such as nuts, cereals, and legumes.The principle cause of iron deficiency anemia in premenopausal women is blood lost during menses.Diarrhea causes one to lose many essential vitaminsGenetic such as Sickle Cell Anemia or ThalassemiaAlso, parasitic infection such as hookworm effects iron in the bloodstream when the body tries to lower its iron levels to try and kill off the parasite.
- This type of anemia has two common effects on human remains that anthropologists have used to study the lifestyles of certain cultures. These are called Porotic Hyperostosis and CribraOrbitalia.However, they can be caused by ricketts, scurvey, or infection so people need to be careful when studying these conditions.
- On the left is an example of active Porotic Hyperostosis on the cranial vault of a 3 year oldOn the right is an example of CribraOrbitalia on the orbital roof, - the top is that of an “active” 4 year old and the bottom is from a “healed” adult
- Including living conditions, household size, diet, waste disposal, food preparation, environment, etc. For example, in the tropics we can deduce that these conditions probably are due to parasitic infection where the water was poor, or in medieval times we can assume that due to the unhealthy living conditions the people suffered from chronic diarrhea. For example, more women then men have these conditions. It has been assumed that this is due to the pressure of childbirth but there is evidence suggesting that this early onset anemia often occurs in childhood and since boys get fed preferentially they have a lower level of mal nourishment.
- Anthropologists decided to study the presence of Porotic Hyperostosis and CribraOrbitalia on skeletons in Italy after the fall of the Roman Empire to try and gain a further understanding of life of that timeAt LucusFeroniae historical data indicates that it was a rural center occupied by workers, war veterans, slaves and liberti (free citizens)At Selvicciola however there was a great deal of typical political, social and economical problems due to the collapse of the empire including epidemics, famines and war
- Studied roughly 150 skeletons between the two sitesThe problems then with childhood iron status can then be related to maternal iron reserves, pre-maturity, long-term breast feeding, poor sanitary conditions and problems related to weaningThis information combined with the studies of the dental disease on the bones led them to believe that a high cereal or carbohydrate diet in the very first years of life would explain the anemic condition related to iron deficiency in terms of both the low absorption of heme iron as well as the lower assimilation of iron because of the fibers and things in cereals. We can then view this type of diet as associated to the age of weaning and related metabolic and immunological stresses at this stage of the life cycle i.e. intestinal infections and diarrhea which would seem to make sense considering the economic, social, and cultural transition from the Roman Age to the Early Middle Ages.