Describe the pathophysiologic process of Anemia. Identify two differential diagnoses and provide the pathophysiology of these two differential diagnoses
You are seeing a patient who is experiencing weariness, pallor, dyspnea with exertion, and palpitations. The patient is in his fifties. The laboratory report shows a low hematocrit of 32, hemoglobin of 9.7, and a reticulocyte count of.47 percent, MCV of 78, and MCHC of 32.1.
Describe the pathophysiology of anemia. Identify two differential diagnoses and explain the pathophysiology of each differential diagnosis.
Anemia occurs when the body’s physiological requirements for a specific number of red blood cells (RBCs) and hemoglobin (Hgb) are insufficient or have a low volume/concentration. When this happens, the oxygen demand rises, and the body adjusts to compensate for the changes. Certain lab tests, such as a complete blood count, can be used to diagnose this illness (CBC). The RBC count, mean corpuscular volume (MCV), reticulocyte, and mean corpuscular Hgb concentration (MCHC) are among the tests performed (Chaparral, 2019). The RBCs will tell you how many red blood cells are circulating. The MCV indicates the size. Normal for an adult is 80-100 femtoliters, or (fl); if it is more than this, it is macrocytic anemia; if it is lower than this, it is microcytic anemia. The MVC can be calculated as follows: HCT x 10/[RBC (Martin, 2019). Another value that is seen is the MCHC. It is computed by dividing the HGB by the HCT. Fatigue and pallor (blood shunting away from the belly to the brain) are caused by a shortage of hgb. Dyspnea on exertion (DOE) is caused by a shortage of oxygen as well. The heart rate increases in an attempt to provide oxygen to the tissues that are deficient in O2.
Iron deficiency anemia, Folate anemia are the differential diagnoses.
Causes of Folate Anemia:
Reduced Consumption
Inadequate nutrition, drunkenness, and infancy
Absorption problems
Malabsorption conditions
IBD (intrinsic gastrointestinal disease)
Oral contraceptives and anticonvulsants
Loss has increased
Hemodialysis
Added Requirement
Pregnancy, infants, disseminated malignancy, and significantly enhanced hematopoiesis are all factors to consider.
Utilization Issues
Antagonists of folic acid
Vitamin B12 or Folic Acid Therapy is ineffective.
DNA synthesis and/or folate metabolism inhibitors are metabolic agents that inhibit DNA synthesis and/or folate metabolism (e.g., methotrexate)
Folate acid and B vitamins are required for the formation of the pigmented, iron-containing component of the Hgb. This can cause problems with red blood cell maturation. Leukopenia can result from this form of anemia (deficiency in white blood cells).
Iron-deficiency Anemia can occur when there is a problem with iron (Fe) absorption or a lack of dietary iron.
References
Chaparral, C.M., and P.S. Suchdev (2019). Epidemiology, pathophysiology, and etiology of anemia in low and middle-income nations. The Annals of the New York Academy of Sciences, 1450(1), pp. 15–31. https://doi.org/10.1111/nyas.14092
L. Martin (2019). What is the definition of a mean corpuscular volume level? https://medicalnewstoday.com/articles/MCV-levels
K., L. McCance, and S., E. Huether (2018). Pathophysiology is the biological basis of disease in both adults and children (8th ed.) Mosby Inc., St. Louis, MO
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1450(1), 15–31, New York Academy of Sciences. https://doi.org/10.1111/nyas.14092
K., L. McCance, and S., E. Huether (2018). Pathophysiology is the biological basis of disease in both adults and children (8th ed.) Mosby Inc, St Louis, MO; ISBN-13: 978-0323583473
J. Turner, M. Parsi, and M. Badireddy (2020). Anemic: A new diagnostic work-up for determining anemia etiologies: a cohort study in general practice patients aged 50 years. 167, BMC Fam Pract. https://doi.org/10.1186/s12875-020-01241-7
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