Blood Dyscrasias - Types, Causes, Diagnosis, and Treatment

What Is Blood Dyscrasia?

The definition of blood dyscrasia is not specific. Mostly, physicians use the term blood dyscrasia to describe any disorder affecting the blood, lymphoid tissue, bone marrow, or blood coagulation proteins. Physicians use this term, especially when unsure of the diagnosis and in unclear medical situations.

Therefore, blood dyscrasia is referred to as a blood-related health problem or hematologic disease. These diseases affect blood plasma or cellular blood components, tissues of the lymphatic system, and bone marrow. Blood dyscrasias can be malignant or benign, common or rare, and vary from mild to fatal. A few examples of blood dyscrasias involve anemia and blood cancers, including lymphomas and leukemias. These conditions may either cause blood coagulation or excessive bleeding.

What Are the Components of Blood?

It is important to know about the components of blood and lymphoid tissues. Blood comprises both plasma (the liquid component) and cells (the cellular component).

1. Blood Cells: Three types of blood cells exist.

• Red Blood Cells- They transport oxygen from the lungs to the whole body.

• White Blood Cells- These cells fight against the infection.

• Platelets- These cells help in the clotting of blood.

2. Plasma: Approximately 55 percent of the blood volume comprises blood plasma. It contains blood clotting proteins, hormones, and other components like nutrients and electrolytes.

3. Bone Marrow: Bone marrow is the site of blood cell origin and is mainly distributed within the body's larger bones.

4. Lymphoid Tissue: Lymphoid tissues like the lymph nodes and spleen may be involved in several blood dyscrasias.

What Are the Causes of Blood Dyscrasias?

Numerous causes and risk factors are associated with blood dyscrasias, including

• Blood Cancers: Certain cancers like leukemias, lymphomas, and multiple myeloma can cause blood dyscrasias. These tumors are characterized by uncontrolled growth of any type of white blood cell, causing problems related to the specific cell type. It may also affect other blood cells may also be affected, such as leukemic cells may lead to overcrowding of the bone marrow resulting in the lesser synthesis of other blood cell types.

• Medications: Both prescribed drugs and illegal drug abuse may cause them. Multivitamins and nutritional supplements can also pose a risk.

• Environmental Exposure: Several environmental exposures, like certain chemicals and radiation, may result in blood dyscrasias.

• Infections: Blood cells are crucial in fighting against infections but can also be damaged by infections.

• Autoimmune Reaction: Antibodies may mistakenly attack blood cells with certain autoimmune diseases.

• Vitamin and Mineral Nutritional Deficiencies: A nutritional deficiency may interrupt blood cell formation that can cause certain blood dyscrasias like anemias. Anemia is caused by iron, vitamin B12, or folic acid deficiency.

• Genetics: Certain gene mutations can be responsible for causing sickle cell disease.

• Combination of Several Factors: A combination of the above risk factors may cause a single type of blood dyscrasia.

How to Categorize Blood Dyscrasias?

There are several different blood dyscrasia types. Pancytopenia is a condition where all the major blood cell types are affected.

1. Red Blood Cells and Hemoglobin Disorders

Some red blood cell dyscrasias are:

• Hemoglobinopathies are hemoglobin-related diseases, including sickle cell disorder. It also includes acquired conditions such as sideroblastic anemia.

• Nutritional disorders include iron deficiency anemia caused by folic acid or vitamin B12 deficiency.

• Aplastic anemia is characterized by red blood cells being produced in limited quantities due to damage to the bone marrow.

• Polycythemia involves the increased production of red blood cells in response to pulmonary disease and other health issues.

• Hemolytic anemia may occur due to the breaking down of red blood cells.

2. White Blood Cell Disorders

Proliferative Disorders: In leukemias, the cancerous white blood cells are present mainly in the blood and the bone marrow. Lymphomas contain neoplastic cells, mostly in lymph nodes (lymphoid tissue).

Leukopenia is a white blood cell deficiency due to chemotherapy, certain drugs damaging the white blood cells, and certain infections usually developing after an acute infection.

Leukocytosis is usually associated with an increase in white blood cell count. One form of white blood cell known as eosinophils is usually elevated for parasitic infections.

3. Platelet Disorders

These disorders are associated with thrombocytopenia (insufficient platelet count) or thrombocytosis (excessive platelets). The normal platelets start to function abnormally. Certain clotting and bleeding disorders may occur.

4. Bone Marrow Disorders

Bone marrow infiltration with abnormal blood cells may be seen in

• Leukemias.

• Solid tumors, like breast cancer, may spread to the bone marrow.

• Myelofibrosis is characterized by replacing bone marrow with fibrous tissue.

• Some connective tissue disorders.

5. Bleeding Disorders

• Platelet Disorders: Caused by a low or increased number of platelets.

• Clotting Factor Deficiencies: Include hemophilia (a condition where the blood does not clot properly).

• Fibrinolytic Defects: Streptokinase (a medicine used in patients with stroke or heart attacks) can interfere with clot formation causing it to break down prematurely.

• Vascular Defects: When there is damage or inflammation of the blood vessels, as in autoimmune conditions.

How to Diagnose Blood Dyscrasias?

• Complete Blood Count (CBC): This test is used to evaluate the number of red blood cells, white blood cells, and blood platelets. If a higher number of immature white blood cells are present, it is suggestive of blood cancer or serious infection.

• Blood Cell Indices: This test helps evaluate the blood cells' size, shape, and quality.

• Reticulocyte Count: This test is used to identify the cause of anemia.

• Peripheral Blood Smear: It is a crucial test to identify morphologically abnormal differences in any type of blood cell.

• Evaluation of Bone Marrow: A biopsy of the bone marrow should be done in certain cases of leukemia.

What Is the Treatment of Blood Dyscrasias?

The management of blood dyscrasias is based on its cause. It is important to treat the underlying disorder. A blood transfusion may be needed for severe anemia until the underlying cause is not treated. Platelet transfusions may be required to stop the bleeding in case of a low platelet count.

Certain medications will be prescribed to stimulate white blood cell production in case of a very low white blood cell count. Measures should be taken to stop the underlying infection. Fresh frozen plasma may be needed in case of bleeding disorder. Missing clotting factors need to be replenished in case of clotting disorders.

Conclusion

Blood dyscrasias affect the blood, bone marrow, or lymphoid tissue. They may range from mild to life-threatening situations. A physician often uses this term during diagnosis before identifying the actual cause of the symptoms. A few blood tests, a thorough physical examination, and a medical history are required to diagnose the disorder. The underlying pathology should be treated to cure the disorder.