Haemorrhagic anaemias

Classification according to cause includes, for example, aplastic anaemia, which is due to bone marrow damage haemorrhagic anaemia due to blood loss haemolytic anaemia due to damage to red cell membranes iron deficiency anaemia due to lack of iron pernicious anaemia due to deficiency in B12 and so on. 

Haemorrhagic anaemia can be caused by large wounds, stomach ulcers or heavy menstrual bleeding. Sudden great loss of blood causes acute anaemia but slow prolonged bleeding can produce chronic anaemia. 

Iron deficiency and haemorrhagic anaemia are treated with replacement in the form of iron salts, usually ferrous sulfate, and an improved diet. Sometimes a blood transfusion is necessary in the short term. 

Deficiency symptoms In vitamin C deficiency scurvy develops. It is characterized by ecchymosis, petechiae, swollen and bleeding gums, subperiosteal haemorrhage, bones are painful to touch, impaired wound healing, anaemia, loosening of teeth and gingivitis. 

Heart stroke, endotoxins or haemorrhagic Serious anaemia Intensive muscular disease... 

Q8 This is unlikely as Maria appears to have a well-balanced food intake and is not trying to diet. In iron-deficiency anaemia, whether caused by poor dietary intake of iron or haemorrhage, RBCs are small. New RBCs entering the circulation are microcytic and carry reduced amount of haemoglobin (hypochromic). The small cells can be visualized on a standard blood film. Premenopausal women are especially likely to suffer from iron-deficiency anaemia following menstrual blood loss and childbirth. However, the blood tests show that Maria s red cells are larger than normal, so she is not suffering from this form of anaemia. 

Anaemias are classified according to the size and haemoglobin content of erythrocytes or to the cause of the condition. In the latter classification bone marrow damage causes aplastic anaemia haemorrhagic and haemolytic anaemia are due to blood loss or damaged red cell membranes respectively, iron deficiency and pernicious anaemia are due to deficiency of iron and vitamin B12 respectively. 

Q8 Since iron deficiency may follow pathological blood loss, some investigation of possible sources of blood loss, particularly into the gut, is advised before treatment of the anaemia is started. Haemorrhage into the gut, for example from erosion or ulceration of the stomach or from sites in the large intestine in colorectal cancer, can be simply detected by testing for (occult) blood in the faeces. 

Deficiency of ascorbic acid leads to scurm/, which is characterised by petechial haemorrhages, haematomas, bleeding gums (if teeth are present) and anaemia. It has a memorable place in the history of therapeutic measurement. 

Iron supplements are often used to treat iron-deficient anaemia. This might occur through severe haemorrhage, dietary deficiency or malabsorption of iron and in pregnancy. Supplements are usually salts of iron. Iron supplements may be administered orally, or sometimes by injection, in the form of ferrous fumarate, ferrous gluconate, ferrous glycine sulphate and ferrous sulphate. 

Pulmonary haemorrhage associated with haemolytic anaemia has been reported in four men exposed to very high concentrations of heated trimellitic anhydride fumes (Zeiss and Patterson, 1993). Increased total antibody levels were found in these men. Using a rat model it has been shown that there was a linear relationship between antibody concentrations and the degree of pulmonary haemorrhage suggesting that immune mechanisms may play a role in this disorder (Zeiss and Patterson, 1993). 

What is this disease A textbook definition would be something like A disease which produces haemorrhaging into tissues, bleeding gums, loose teeth, anaemia and general weakness. However, contemporary descriptions of individual cases bring home to us the unpleasantness of scurvy. Thus Thomas Stevens wrote from a ship travelling from Lisbon to Goa in 1579 ... 

There are few absolute contraindications to the use of thiopental sodium, but porphyria is generally considered to be completely restrictive [61]. Extra care with both dosage and rate of administration is required in cases of severe haemorrhage, bums dehydration, severe liver disease, status asthmaticus, severe anaemia, raised intracranial pressure, and some metabolic diseases such as thyrotoxicosis and diabetes [61]. 

Detection eggs in untreated preparation if negative enrichment. In blood anaemia of the post-haemorrhagic type. Remarks epidemics formerly common in mining operations. 

Apart from effects on the oral tissues, the joints become swollen and painful and, since lack of intercellular cement makes the walls of the capillaries fragile, tiny haemorrhages (petechiae) appear under the skin. The bones too become fragile and wounds fail to heal properly. Since the scar tissue consists mainly of amorphous material with few collagen fibres, it lacks tensile strength and readily breaks down. A secondary anaemia may also develop. 

These infants with severe combined immunodeficiency are exquisitely susceptible to graft-versus-host disease which has been observed in them following administration of peripheral blood, fetal liver cells, or histoincom-patible bone marrow " The course of the reaction much resembles the disease of mice and is rapidly fatal in 10-14 days. It is characterized by fever, a maculopapular rash involving the volar surfaces, diarrhoea with protein-losing enteropathy and edema, haemolytic anaemia and thrombocytopenia. Haemorrhage into the gut or lung is usually the terminal event. Donor cells are most abundantly evident in the spleen and liver and less so in skin and kidney. Splenic enlargement resembles also the observation in mice and correlates with the severity of the reaction. 

In a phase 1 trial, 20 patients with advanced RCC were treated with everolimus and sunitinib grade 3 toxicities noted were herpes stomatitis, leucopenia, vomiting. Streptococcus viridans endocarditis, gastrointestinal haemorrhage, mucositis, febrile neutropenia and thrombocytopenia with bleeding. Grade 4 toxicities were anaemia and pulmonary embolism [141. 

Effects of Vitamin C Deficiency.—(i.) Infantile Scurvy.—This condition is found in children fed exclusively on sterilised or artificial dietaries, or by mothers whose milk is deficient in ascorbic acid. After a period of anaemia and irregular growth, the characteristic syndrome appears sore gums, periosteal haemorrhages at the joints, subcutaneous haemorrhages and haematuria. 

Vitamin E has been used successfully in the therapy of progressive neuromuscular disease in children with liver or bile dysfunction and a number of diseases, which afflict prematurely bom infants, such as haemolytic anaemia, intraventricular haemorrhage and retrolental fibroplasias, which can produce blindness. 

The number of diseases reported in finfish and the methods used to detect the causative agents is vast (reviewed by Adams, 2009). The diseases currently listed as notifiable by the OIE include epizootic haematopoietic necrosis (EHN) epizootic ulcerative syndrome (EUS) gyrodactylosis (Gywdactylus 5fl/ ris) infectious haematopoietic necrosis (IHN) infectious salmon anaemia (ISA) koi herpesvirus disease (KHVD) red sea bream iridoviral disease (RBID) spring viraemia of carp (SVC) viral haemorrhagic septicaemia (VHS) (OIE, 2011). 

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