Items in AFP with MESH term: Thalassemia
'Common' Uncommon Anemias - Article
ABSTRACT: Of the uncommon anemias, "common" types include the anemia of renal disease, thalassemia, myelodysplastic syndrome and the anemia of chronic disease. These conditions may be suggested by the clinical presentation, laboratory test values and peripheral blood smear, or by failure of the anemia to respond to iron supplements or nutrient replacement. The principal cause of the anemia of renal disease is a decreased production of red blood cells related to a relative deficiency of erythropoietin. When treatment is required, erythropoietin is administered, often with iron supplementation. In the anemia of chronic disease, impaired iron transport decreases red blood cell production. Treatment is predominantly directed at the underlying condition. Since iron stores are usually normal, iron administration is not beneficial. Thalassemia minor results from a congenital abnormality of hemoglobin synthesis. The disorder may masquerade as mild iron deficiency anemia, but iron therapy and transfusions are often not indicated. In the myelodysplastic syndrome, blood cell components fail to mature, and the condition may progress to acute nonlymphocytic leukemia. The rate of progression depends on the subtype of myelodysplasia, but the leukemia is usually resistant to therapy.
Evaluation of Microcytosis - Article
ABSTRACT: Microcytosis is typically an incidental finding in asymptomatic patients who received a complete blood count for other reasons. The condition is defined as a mean corpuscular volume of less than 80 µm3 (80 fL) in adults. The most common causes of microcytosis are iron deficiency anemia and thalassemia trait. Other diagnoses to consider include anemia of chronic disease, lead toxicity, and sideroblastic anemia. Serum ferritin measurement is the first laboratory test recommended in the evaluation of microcytosis. Low ferritin levels suggest iron deficiency. Once a presumptive diagnosis of iron deficiency anemia has been made, an underlying source for the deficiency should be determined. Iron deficiency anemia in adults is presumed to be caused by blood loss; the most common source of bleeding is the gastrointestinal tract. The possibility of gastrointestinal malignancy must be considered. If the serum ferritin level is not initially low, further evaluation should include total iron-binding capacity, transferrin saturation level, serum iron level, and possibly hemoglobin electrophoresis. Anemia of chronic disease is suggested with low iron levels and decreased total iron-binding capacity. Patients with beta-thalassemia trait usually have elevated levels of hemoglobin A2.