This document defines and classifies various types of anemia, including iron deficiency anemia, megaloblastic anemia, aplastic anemia, hemolytic anemia, sickle cell anemia, and thalassemia. It discusses their causes, signs and symptoms, and methods of diagnosis. Laboratory tests discussed include complete blood count, serum iron levels, ferritin test, and bone marrow tests. The treatment of anemia depends on its underlying cause, and may include iron supplements, vitamin supplements, blood transfusions, and medications. Preventive measures include consuming an iron-rich diet with foods like red meat, fish, and leafy greens.

1. Definition ,Classification and Laboratory
Diagnosis of Various Types of Anemia
Presented By:
Saikat Pal

3. Definition:
▪ The term anemia is derived originally from
the Greek word ‘an-haima’, which means
“lack of blood”.
▪ Anemia happens when you do not have
enough red blood cells.
▪ Having anemia, also referred to as low
hemoglobin.
▪ Anemia is the most common blood
disorder, and according to the National
Heart, Lung, and Blood Institute, it affects
more than 3 million Americans.
Anemia

4. Signs & Symptoms
• Pale or yellowish skin
• Fatigue
• Fast or irregular heartbeat
• Weakness
• Shortness of breath
• Lightheadedness or dizziness
• Cold hands and feet
• Chest pain
• Headache
• Leg cramps

6. Causes of Anemia
• Excessive Bleeding
• Leaky Gut
• Low Stomach Acid
• Iron Deficiency
• B12 Deficiency
• Folate Deficiency
• Intestinal Disorders
• Infections
• Kidney Disease
• Liver Disease
• Pregnancy
• Autoimmunity

7. Image Link: https://drjockers.com/anemia/

8. Causes & Risk Factor of Anemia

9. Types of Anemia
• Microcytic (Iron Deficiency) Anemia
• Megaloblastic (Vitamin Deficiency) Anemia
• Aplastic Anemia
• Hemolytic Anemia
• Sickle Cell Anemia
• Pernicious Anemia
• Thalassemia

10. Types of Anemia
On the basis of Morphology:
▪ Microcytic Anemia
▪ Normocytic Anemia
▪ Macrocytic Anemia

11. Types of Anemia
Microcytic Anemia:
• If the red blood cells are smaller in size than normal is called microcytic anemia
▪ Iron deficiency anemia
▪ Thalassemia
Normocytic Anemia:
• If the red blood cell are normal in size but less in amount is called Normocytic Anemia
Macrocytic Anemia:
• if he red blood cells are larger than normal is called macrocytic Anemia
▪ Pernicious anemia

12. Iron Deficiency Anemia
▪ Iron is very important in maintaining many body functions, including the
production of hemoglobin, the molecule in your blood that carries oxygen.
▪ Iron from the food you eat is absorbed into the body by the cells that line the
gastrointestinal tract. The iron is then released into the bloodstream, where a
protein called transferrin attaches to it and delivers the iron to the liver. Iron is
stored in the liver as ferritin and released as needed to make new red blood cells
in the bone marrow.
▪ It occurs when your body doesn’t have enough iron, which your body needs to
make hemoglobin. When there isn’t enough iron in your blood, the rest of your
body can’t get the amount of oxygen it needs.

13. Iron Deficiency Anemia
Signs and symptoms:
▪ Extreme fatigue
▪ Weakness
▪ Pale skin
▪ Chest pain, fast heartbeat
Causes:
• Blood loss
• A lack of iron in your diet
• An inability to absorb iron
• Pregnancy

14. Megaloblastic Anemia
▪ When RBCs aren’t produced properly, it results in megaloblastic anemia.
Because the blood cells are too large, they may not be able to exit the bone
marrow to enter the bloodstream and deliver oxygen.
▪ The two most common causes of megaloblastic anemia are deficiencies of
vitamin B12 and folate.
Signs & symptoms:
• Shortness of breath
• Muscle weakness
• Diarrhea
• Nausea

15. Aplastic Anemia
▪ Aplastic anemia is a condition that occurs when your body stops producing
enough new blood cells. The condition leaves you fatigued and more prone to
infections and uncontrolled bleeding.
▪ When a person has aplastic anemia, their bone marrow does not create the
blood cells it needs.
▪ Aplastic anemia is caused by damage to the bone marrow.

16. Aplastic Anemia
Symptoms:
• Dizziness excessive
• fatigue
• Weakness
• Rapid heart rate
Causes:
• Radiation and chemotherapy treatment
• Exposure to toxic chemicals
• Use of certain drugs
• Autoimmune disorders

17. Hemolytic Anemia
▪ When the destruction of red blood cells outpaces your bone marrow’s production
of these cells, hemolytic anemia occurs.
▪ Hemolytic anemia is a disorder in which red blood cells are destroyed faster than
they can be made. The destruction of red blood cells is called hemolysis.
▪ Extrinsic hemolytic anemia develops by several methods, such as when the
spleen traps and destroys healthy red blood cells, or an autoimmune reaction
occurs.
▪ Intrinsic hemolytic anemia develops when the red blood cells produced by your
body don’t function properly.

18. Sickle Cell Anemia
▪ Sickle cell anemia is a genetic disease of red blood cells (RBCs). Normally, RBCs
are shaped like discs, which gives them the flexibility to travel through even the
smallest blood vessels.
▪ With this disease, the RBCs have an abnormal crescent shape resembling a sickle.
This makes them sticky and rigid and prone to getting trapped in small vessels,
which blocks blood from reaching different parts of the body. This can cause pain
and tissue damage

19. Sickle Cell Anemia
Cause:
▪ Sickle cell anemia is caused by a change in the gene that tells the body to make
the iron-rich compound in red blood cells called hemoglobin. Hemoglobin
enables red blood cells to carry oxygen from the lungs throughout the body. The
hemoglobin associated with sickle cell anemia causes red blood cells to become
rigid, sticky and misshapen.
▪ For a child to be affected, both mother and father must carry one copy of the
sickle cell gene — also known as sickle cell trait — and pass both copies of the
altered form to the child.

20. Pernicious Anemia
▪ Pernicious anemia is one cause of vitamin B12 deficiency anemia. It’s thought to
mainly be caused by an autoimmune process that makes a person unable to
produce a substance in the stomach called an intrinsic factor.
▪ This substance is needed to absorb dietary vitamin B12 in the small intestine.
Vitamin B12 is a required nutrient that helps allow proper red blood cell production
and function in the body.
▪ This type of anemia is called “pernicious” because it was once considered a deadly
disease. This was due to the lack of available treatment.
Common symptoms:
✓ fatigue, weakness, chest pain, weight loss, pale skin

21. Thalassemia
▪ Thalassemia is an inherited blood disorder in which the body makes an abnormal
form of hemoglobin. Hemoglobin is the protein molecule in red blood cells that
carries oxygen.
▪ The disorder results in excessive destruction of red blood cells, which leads to
anemia.
▪ Hemoglobin molecules are made of chains called alpha and beta chains that can
be affected by mutations. In thalassemia, the production of either the alpha or
beta chains are reduced, resulting in either alpha-thalassemia or beta-thalassemia

22. Diagnosis
➢ Completeblood count (CBC)
• The CBC Blood Test measures your hemoglobin level and can show the number and
size of red blood cells. It can also indicate if levels of other blood cells like white
blood cells and platelets are normal.
➢ Reticulocyte count
• A Reticulocyte count is a blood test that measures levels of immature red blood
cells called reticulocytes. It can help your doctor determine if your bone marrow is
producing enough new red blood cells.

23. Diagnosis
➢ Serum iron levels
• A Serum iron level is a blood test that measures the total amount of iron in your
blood. It can show if iron deficiency is the cause of anemia.
➢ Ferritin test
• A Ferritin test is a blood test that analyzes iron stores in your body.
➢ Vitamin B12 test
• The Vitamin B12 test is a blood test that measures your vitamin B12 levels and
helps your doctor determine if these levels are too low.

24. Diagnosis
➢ Bone marrow tests
• Testing of a bone marrow aspirate or biopsy can help your doctor see if your bone
marrow is functioning normally. These types of tests can be very helpful if
conditions like leukemia, multiple myeloma, or aplastic anemia are suspected.
➢ Coombs test
• The is a blood test that looks for the presence of autoantibodies that are targeting
and destroying your own red blood cells.

25. Diagnosis
➢ Folic acid test
• A Folic acid test is a blood test that measures your folate levels and can indicate if
this level is too low.
➢ Fecal occult blood test
• This applies a chemical to a stool specimen to see if blood is present. If the test is
positive, it means that blood is being lost somewhere in the gastrointestinal tract.
Health conditions like stomach ulcers, ulcerative colitis, and colon cancer can cause
blood in stool.

26. Treatment of Anemia

27. Iron-deficiency Anemia:
• is mainly treated with iron supplements and intake of a diet high in iron. In some cases,
iron is also given through IV infusion. If excessive bleeding is what causes the iron
deficiency, treat the underlying cause of bleeding.
Aplastic Anemia:
• include bone marrow transplant (stem-cell transplant), blood transfusions, or
medications.
Vitamin deficiency anemia:
• can be treated with dietary supplements. Vitamin B-12 is administered through
injection if you have pernicious anemia. Intake of folic acid supplements can help in
Folate deficiency anemia treatment.

28. Anemia of Chronic Disease:
• There is no particular treatment for anemia of chronic disease. Treating the
underlying disorder is the primary step. Erythropoietin stimulating agents can help in
stimulating the production of RBCs.
Sickle cell Anemia:
• Treatment involves intravenous fluids, oxygen therapy, blood transfusions, and pain-
relieving medications. Hydroxyurea (Droxia, Hydrea, Siklos), an oral medication, can
increase fetal hemoglobin and make the RBCs bigger. A bone marrow transplant is
also a treatment option to cure this type of anemia.
Hemolytic Anemia:
• Can be treated by plasmapheresis, immunosuppressive therapy, splenectomy,
corticosteroid medicines, and treatments for infections.

29. Preventive Measures
Iron-rich diet can help prevent common types of anemia and increase your energy
levels.
• Broccoli
• Red meat
• Fish
• Eggs
• Soy products
• Green leafy vegetables
• Dried fruits

30. Increasing folate (a type of vitamin) intake is also linked with increased
‘heme’ production. Heme is an important component of hemoglobin that
helps to carry oxygen. Here are some food items that are considered a good
source of folate:
• Peanuts
• Beef
• kidney beans
• Spinach
• Black-eyed peas
• Rice
• Lettuce
Preventive Measures

31. Foods rich in vitamin A include:
• Fish
• Liver
• Sweet potatoes
Foods high in beta-carotene include yellow, red, and orange fruits and vegetables,
such as:
• Carrots
• Sweet potatoes
• Mangoes
Preventive Measures

32. Summary
of
Anemia

33. References:
1. Josephs, H. W. (1958). Absorption of Iron as a Problem in Human Physiology: A Critical Review. Blood: The
Journal of Hematology.
2. Hennek, J. W. and Kumar, A. A. and Wiltschko, A. B. and Patton, M. R. and Lee, Si Yi R. and Brugnara, C. and
Adams, R. P. and Whitesides, G. M. (2016). Diagnosis of Iron Deficiency Anemia Using Density-based
Fractionation of Red Blood Cells. Lab Chip.
3. American Society of Hematology (2016). Anemia. American Society of Hematology: Helping Hematologists
Conquer Blood Diseases Worldwide.
4. Kansagara D, Dyer EAW, Englander H, Freeman M, Kagen D, Treatment of Anemia in Patients
5. ANJUM, A., MANZOOR, M., MANZOOR,N. AND SHAKIR, H.A., 2015. Prevalence of anemia during pregnancy in
district Faisalabad, Pakistan Punjab Univ. J. Zool., 30(1): 15-20.
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4. https://www.lalpathlabs.com/blog/an-overview-of-anemia-types-symptoms-risk-factors-complications-
prevention-diagnosis-its-treatment/
5. https://www.researchgate.net/figure/Iron-deficiency-anaemia-risk-factors_fig2_268437723 [accessed 13 May,
2022]
6. https://drjockers.com/anemia/
7. https://labpedia.net/anemia-classification-diagnosis-and-routine-workup/