In the morphological study of red blood cells, which tend to retain all their inherent characteristics throughout life, various deviations from the norm are best detected.
Erythrocyte characteristics
In shape, erythrocytes resemble biconcave discs with a diameter of 7-8 microns, their volume averages 80-100 femtoliters, their color is normochromic. In the case of pathological changes in red blood cells with microcytosis, macrocytosis, normocytosis, hypochromia and hyperchromia, anemic conditions are most often detected. The concept of "microcytosis" is characterized by the presence in erythrocytes of a large number of small midget cells. This indicates the development of microcytic anemia.
Deviations from the norm
Red blood cells perform numerous and very important functions in the body. They can also tell about deviations in their size compared to normal values (80-100 fl or microns3):
- if they are less than normal (MCV in the hematology analyzer <80 fl) - then this condition is called microcytosis;
- more than normal(MCV>100 fl) – macrocytosis;
- and if they have normal sizes, then this is considered normocytosis.
Coloring
A significant role in the diagnosis of various anemias is assigned to such a laboratory indicator as color. There are respectively hypochromia, hyperchromia and normochromia. As a result of a violation of the synthesis of red pigment (it is also called hemoglobin), due to a lack of iron, microcytosis accompanies hypochromia. This pathology is called microcytic anemia.
In this case, the size of red blood cells and their color are constant signs of the disease. For what reason microcytosis occurs, we will analyze in this article.
Microcytosis - what is it?
Of the three types of erythrocyte anisocytosis, microcytosis is the most common. It is characterized by the presence in the total number of erythrocytes of a large number of red blood cells that are unnaturally reduced in volume.
If microcytosis is detected in blood tests, the doctor may assume that the patient has developed microcytic anemia. That is, it was the main reason for the increase in microcytes in human blood. The specialist must definitely find out the reason for such a deviation, especially if such a phenomenon has not been diagnosed before, but was discovered for the first time. Many anemic conditions have this feature, so a differential diagnosis is required.
Some types of anemia can cause microcytosis. What came first - anemia or a decrease in the size of red blood cells? Thisa question often asked.
Due to complex biochemical reactions occurring in the body, there is a relationship between the causes of anemia and the appearance of microcytes in the blood. Or hypochromic anemia occurs precisely because of a decrease in the size of red blood cells.
Iron deficiency anemia
The most common among all is precisely iron deficiency microcytic anemia associated with a lack of iron in the body.
It includes a whole group of iron deficiency states that are formed for various reasons:
- Anemia caused by hemoglobinuria (in which red blood cells are damaged and hemoglobin is released into the plasma, this condition is called hemolysis, which is primarily reflected in the urine) and hemosiderinuria (hemoglobin accumulates in the kidneys and the product of its oxidation, hemosiderin, is removed in the urine).
- Chronic post-hemorrhagic iron deficiency anemia - the condition is formed due to many diseases that are accompanied by bleeding (uterine, nasal, renal, blood loss from the gastrointestinal tract).
- Anemias associated with:
- The fact that the intake of iron with food decreases (with vegetarianism or other diets, forced or targeted, limiting the saturation of the body with iron and protein).
- By increasing the body's need for this irreplaceable chemical element (in case of pregnancy, breastfeeding, frequent childbirth, donation).
- The fact that the absorption and transport of iron is disturbed (with chronicinflammatory or malignant process localized in the area of the digestive tract or in the pancreas, while its secretory function is disturbed, with extensive resection of the intestine).
What other anemias exist?
There are, in addition to iron deficiency anemia, depending on the size of the erythrocyte and color, and other hematological pathologies:
- Hemoglobinopathy (thalassemia, Minkowski-Choffard disease, hereditary microspherocytosis, H hemoglobinopathy).
- Sideroblastic microcytic anemia is a pathological condition in which iron metabolism is disturbed. With such anemia, there is a frequent manifestation of microcytosis, hypochromia, a reduced level of iron in erythrocytes, an increased level in the blood (due to the fact that this element is not taken by the bone marrow to produce hemoglobin). Pathology can be acquired, which often develops in adults and accompanies other diseases (with inflammatory processes, malignant tumors, chronic alcoholism), and hereditary (a defective gene is located on the X chromosome).
- Anemia associated with exposure to chronic infection.
- Anemic condition due to poisoning with s alts of heavy metals, in particular lead, which negatively affects the utilization of iron and the production of hemoglobin. The characteristic signs of such a pathology will be - microcytes, hypochromia, coarse intracellular inclusions (Jolly bodies, basophilic granularity, Cabot rings) will be found in the blood.
- Rare specieshypochromic microcytic anemia - the causes of their occurrence are due to congenital anomalies in iron metabolism, violations of the processes of transport and reutilization of this valuable element, and the absence of an iron-binding protein.
How does hypochromic microcytic anemia manifest itself in children?
Hemogram parameters should be under control, it is shown without fail to a growing organism.
Hypochromia and microcytosis during a general blood test, along with other signs of ill he alth (excessive weight gain or loss, not a natural need to taste and even eat inedible foods, changes in behavior, decreased concentration) indicate the presence the child has anemia due to insufficient iron levels. After all, the synthesis of hemoglobin (red blood pigment) depends only on this chemical element.
It is also a carrier of oxygen through tissues and organs, and when it decreases, unpleasant symptoms characteristic of anemia appear.
How to prevent this?
Children are more likely to experience these disorders. This is due to the peculiarities of iron metabolism and nutrition. The diet should be built in such a way that the baby has enough iron. But it doesn't always work out.
From mother's milk, which absorbs iron more efficiently than cow's or goat's milk, there is little risk of anemia.
After a year of life, foods with a high content ofthis element for the normal development of the body.
If there are signs of microcytic anemia (we examined the reasons), it is easy to determine by the blood picture, because the hemoglobin level will be reduced.
What does low iron entail?
When the level of iron in the body decreases, the following biochemical reactions will follow:
- decrease in stocks of heme-forming components in the bone marrow and liver tissue;
- decrease in secretion and ferritin levels (the main iron storage protein);
- increase in serum total iron-binding capacity of blood;
- an increase in the level of free erythrocyte protoporphyrins, which have nothing to connect to to form heme;
-
decrease in the activity of iron-containing enzymes inside cells.
microcytic hypochromic anemia
As the pathological decrease in iron in the blood progresses and, accordingly, the level of hemoglobin falls, more and more erythrocytes will change color, their size and external outlines will decrease. Ultimately, this will lead to the deformation of erythrocytes, their transformation into microcytes. And along with microcytosis, hypochromia and poikilocytosis will be noted in red blood cells.
This will all be reflected in the hemogram and biochemical blood test. Decreased hemoglobin levels, altered serum iron values, erythrocyte indices will change, hypochromia and microcytosis will appear in the general blood test - all this will confirm the development of hypochromic microcytic anemia.
FullCertainly, there is no certainty that iron deficiency anemia has developed in a baby or an adult.
Therefore, the pathological condition must be differentiated from other types of anemia. For example, it can be caused by lead poisoning (with basophilic inclusions in erythrocytes, an increase in the level of lead in the blood serum, the appearance of free erythrocyte protoporphyrins and captoporphyrins in the urine). It can also be thalassemia (it can be suspected with an increase in blood HbA2, HbF). When diagnosed with microcytic anemia, treatment should be timely.
How to get rid of anemia?
Normal iron levels need to be replaced. The patient menu is being revised.
If anemia is associated with constant blood loss, their cause is eliminated. With heavy menstruation, treatment by a gynecologist will be required. The acute or traumatic nature of bleeding is eliminated by surgical intervention. Ulcerative bleeding involves the treatment of diseases of the gastrointestinal tract.
When a microelement deficiency provokes the body itself, ready-made preparations are administered in the form of tablets or injections. They have contraindications and side effects. Iron overdose is just as dangerous as iron deficiency.
We have examined iron deficiency hypochromic microcytic anemia in detail.
