Anemia, hemolytic pernicious

Deficiency conditions Pernicious anemia, hemolytic anemia, hyperthyroidism, bowel and pancreatic mahgnancies, gastrectomy, GI lesions, neurologic damage, malabsorption syndrome, metabohc disorders, renal disease... 

The incidence and severity of Salmonellosis is increased in the following conditions or comorbidities. Achlorhydria, pernicious anemia, impaired immune response, HIV infection, malnutrition, chronic steroid administration, frequent administration of antibiotics which affects intestinal flora and lowers resistance of colonization, lymphoproliferative diseases, malignant tumors, schistosomiasis, chronic hemolytic syndromes (sickle cell disease), malaria and inflammatory bowel disease, mainly ulcerative cohtis. 

Elevations of serum iron occur in various other pathological conditions hemolytic anemia, lead toxicity, pyridoxine deficiency, pernicious anemia, acute liver necrosis, and iron poisoning. Serum transferrin levels usually decrease in these cases and the percent saturation increases in response to increased iron in the extracellular fluid. Desferrioxamine, a siderophote from actinomycetes, has been used to treat patients with acute iron toxicity (30,31]. The toxicity of iron was reviewed in a previous volume of this series [6]. 

As may be anticipated, the erythrokinetics in thalassemia are somewhat different from what they are in other types of hemolytic anemia, in that much of the red cell destruction seems to involve red cell precursors rather than mature erythrocytes. In this, thalassemia resembles pernicious anemia. In either case, it is not known what factor is involved in determining death of the immature cells, or whether the same factor is responsible for death of mature and immature cells [36]. 

Porphyrinuria may be defined as an increase of ether-soluble porphyrins, such as coproporphyrin, in the urine caused by various disturbances. Coproporphyrin III is said to predominate in lead and chemical poisoning, in aplastic anemia, poliomyelitis, and Hodgkin s disease. Coproporphyrin I is said to predominate in pernicious anemia, leukemia, hemolytic jaundice, nonalcoholic cirrhosis, obstructive jaundice, and infective hepatitis. Some of these effects have been considered in the sections on coproporphyrin and protoporphyrin. 

Thus destruction of red cells in pernicious anemia is not due solely to an inherent abnormality in the red cells there must also be an extra-corpuscular mechanism. The existence of a hemolytic agent in the blood of patients with pernicious anemia is discussed by Paschkis and Taylor (1934), Dock (1938), and Bloomfield (1944). 

The labeling technique has been used to study the life-span of erythrocytes in patients with anemias and porphyrias (343, 359). In a hemolytic anemia patient most of the labeled stercobilin was found to be excreted some 20 days after feeding of labeled glycine. In sickle cell anemia it was concluded that a random destruction of erythrocytes took place to compensate for this destruction the rate of hemoglobin formation was nearly tripled. In pernicious anemia an abnormal pattern of erythrocyte destruction was also found but the erythrocyte life-span returned to normal after liver therapy. 

Anemia is defined by abnormally low circulating hemoglobin concentrations. A variety of etiologies exist for anemia, including dietary deficiencies of folate or vitamin B12 (pernicious or macrocytic anemia), infections and inflammatory states (anemia of chronic disease), and conditions that result in insufficient production of red blood cells (aplastic anemia) or excessive destruction of red blood cells (hemolytic anemia). However, worldwide, the most prevalent form of anemia is that of iron deficiency, which causes anemia characterized by hypochromic and normo- or microcytic red blood cells. Iron deficiency anemia remains a health problem in both the developed and the developing world. This article discusses the metabolism of iron the assessment of iron deficiency iron requirements across the life span and the consequences, prevention, and treatment of iron deficiency and iron deficiency anemia. 

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