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Sunday, January 25, 2015

Hymolytic anemia or thallasemia

The patient feels well. Once blood values return to normal, usually just a single injection of vitamin B12 per month suffices for good health. There is no primary prevention for ordinary pernicious anemia. But there are other conditions that lead to vitamin B12 deficiency and to an anemia that resembles the pernicious type. They include destruction or removal of the stomach, regional ileitis, removal of the ileum (the lower portion of the small intestine), and fish tapeworm disease. When anemia stems from these conditions, primary prevention is possible. Fish tapeworm disease can be avoided by eating only well-cooked fish. 

When the stomach or ileum is destroyed or removed, injections of vitamin B12 can be given regularly to prevent the anemia from developing. Hemolytic Anemia In this type of anemia, red blood cells are destroyed. Hemolytic anemia may be congenital or acquired, acute or chronic. In addition to symptoms common to other anemias such as fatigue and shortness of breath, hemolytic anemia usually produces some degree of jaundice because the destroyed red cells release their hemoglobin which is converted into jaundice pigments

Sometimes an acute form of hemolytic anemia appears suddenly, with chills, fever, nausea, and vomiting, abdominal pain. The cause may be a medicine to which the patient is sensitive, bacterial or malarial infection, metastatic cancer, or Hodgkin's disease.


 If the basic cause can be removed (e.g., an offending medicine) or cured (e.g., malaria), the outlook is good. Usually the situation calls for prompt hospitalization. In the, hospital, with injections of fluids, transfusions of packed red cells, and use of corticosteroid medicines, the patient makes a good recovery. Some hemolytic anemias are chronic and may last for years.  . It occurs in 1 of 1,500 American blacks. Many patients live to age o and beyond. 

When complications occurs, they are apt to be infarctions III blood vessels of lungs or spleen, bleeding from the kidney, or eye probe retinal detachment or hemorrhages into the rear fluid compartment of the eye, the vitreous). Hemolytic anemia other than sickle- cell may result from transfusion of mismatched blood, which should be preventable with today's knowledge and techniques for blood grouping. 

It may also result from Rh incompatibility (see page 562). In addition, this type of anemia may be produced by some industrial poisons (such as benzol, aniline, TNT), and sometimes by such substances as sulfonamide medications, quinine, lead, snakevenom, castor and fava beans. Outcome will depend on severity of the anemia and on how quickly the cause can be deter- mined and eliminated, as well as on prompt treatment with fluids, trans- fusions, and corticosteroid medications. Another hereditary type of hemolytic anemia is thalassemia, which is subdivided into major and minor categories. 

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