Microcytic Anemia - Symptoms, Types, Diagnosis, and Treatment

What Are Microcytic Anemias?

The generation of abnormally small red blood cells is a characteristic of microcytic anemia. The decreased production of hemoglobin, the most important component of red cells, is the primary cause of the diminutive size of these cells. Microcytic anemia is caused by a lack of globin product, restricted iron delivery to the heme group of hemoglobin, a lack of iron delivery to the heme group, and errors in the synthesis of the heme group. Other causes include a lack of iron delivery to the heme group.

What Are the Symptoms of Anemia?

There are no obvious symptoms in the initial stages of microcytic anemia; however, once the anemia has progressed to a more severe stage, those symptoms will become apparent. It includes the following symptoms:

• Pale skin (grayish skin).

• Eyelids and nail beds that are pale.

• Lack of energy.

• Concentration difficulty.

• Amplification of the spleen.

• Dizziness.

• Insufficiency of breath.

• Irregular heart rate.

• Pica is a psychiatric disorder characterized by compulsive swallowing of non-food objects.

What Are the Types of Microcytic Anemia?

There are several different types of microcytic anemia.

Iron Deficiency Anemia: Anemia caused by a lack of iron is the most frequent form of the condition. It is more likely for women to suffer from iron insufficiency than it is for men since women, on average, lose more iron than men do due to insufficient iron intake from their diets. Pregnancy can also be a contributing factor. Iron deficiency anemia is a condition that can affect athletes. Iron is lost through the blood in the gastrointestinal tract, and exercise-induced hemolysis causes iron to be lost through the urine. Insufficient iron absorption has been hypothesized to contribute to both iron shortage and the inflammation that might be brought on by vigorous exercise. Obesity and the surgical treatment of obesity are both risk factors since obese patients frequently suffer from iron deficiency. This occurs due to an increased hepcidin level linked to reduced iron absorption.

Chronic Disease: The underlying causes of anemia brought on by chronic illness are complicated and multifaceted. This disorder is linked to a disruption in the immunological system, leading to decreased erythrocyte survival, poor cell proliferation of erythroid progenitors, increased iron intake, and increased cell retention in the reticuloendothelial system. There are a variety of illnesses that might cause the body to create fewer red blood cells. This can result in either normocytic anemia or microcytic anemia. An inflammatory mechanism that heightens the condition and hinders the red blood cells from working normally. Infections such as tuberculosis, HIV, or endocarditis might have this effect, resulting in decreased iron absorption or use. Inflammatory diseases such as rheumatoid arthritis and Crohn's disease, diabetes mellitus, renal illness, and cancer.

Lead Toxicity: Lead poisoning can be caused by contaminated drinking water and being exposed to high industrial pollutants.

Thalassemia: Thalassemia is a form of anemia that is caused due to a genetic abnormality in the patient. The patient's red blood cells do not produce enough healthy blood cells. Mutations in the genes necessary for normal hemoglobin synthesis are the root cause of this disorder.

Sideroblastic Anemia: A mutation in the gene that causes sideroblastic anemia can be passed down from generation to generation. A condition that develops later in life and hinders the body's ability to integrate iron into the component for hemoglobin by affecting the bone marrow's capacity to make normal blood cells is another potential cause of this condition. It is also possible for this condition to be caused by an infection.

Vitamin B6 Deficiency: A deficit may develop for several reasons, including an absence of vitamin B6 in the food, difficulties in the body's ability to absorb the vitamins, or excessive consumption of the vitamins.

How Can Microcytic Anemia Be Diagnosed?

An evaluation of the patient's physical state can reveal various symptoms caused by microcytic anemia. Therefore, a blood test and other more specialized blood tests to detect the etiology of microcytic anemia are necessary to diagnose the condition.

• MCV: The red blood cell volume can be measured using the mean cell volume (MCV), which gives an average of one million cells. Passing cells one at a time through a small aperture in automated equipment that uses light scattering, refraction, or diffraction to estimate size in three dimensions is a common method for measuring size. This method provides an accurate representation of the size of the cell in all three dimensions.

• RDW: The RBC distribution width, also known as the RDW, is typically used to determine the variation in RBC size. This is done by comparing the RDW to the width of the MCV histogram. If there is only one cell population that is identical, then the RDW will be quite small since the RBC volume distribution will be closely concentrated all around the mean. If there is a large range of cell sizes, the histogram will have a broad peak; if there are two distinct populations, the histogram will have two narrow peaks; the RDW for both of these non-uniform populations will be increased. The RDW typically falls between 11.5 percent to 14.5 percent, its normal range. There is not a single circumstance that perpetually results in a decreased RDW. Hence, the RDW is either at its typical level or has increased.

• Blood Smear: Under the microscope, red blood cells affected by microcytic anemia will have a diminished size and a generally pale appearance.

• Genetic Test: This test can assist in the diagnosis of thalassemia as well as other genetic causes of sideroblastic anemia.

• Iron Level: Deficiency can be determined by measuring the amount of iron in the blood.

• Lead Level: Due to the fact that lead, a dangerous metal, may be quantified from a blood sample, the test is carried out to confirm any lead toxicity.

• Urinalysis: The test consists of collecting urine and analyzing it to establish if there is any blood present in the urine; if there is blood present in the urine, this indicates either hemolysis or bleeding in the body.

• Ultrasound: The imaging test might be helpful in determining the cause of bleeding if there are any other chronic illnesses present, such as cancer or structural causes.

• Colonoscopy: The invasive procedure can pinpoint the location of the bleeding in the intestines as the cause.

• Endoscopy: This examination is carried out to detect any bleeding, cancer, or ulcers that may be present in either the esophagus or the stomach.

• Bone Marrow Biopsy: The test aims to identify any diseases or cancers that may exist in the bone marrow. The marrow was extracted from the bone in the same manner as in the test.

What Is the Treatment Plan For Microcytic Anemia?

The treatment strategy is determined by the underlying cause of the problem. There are several different treatments available for microcytic anemia. Some of these treatments assist in alleviating the symptoms, while others assist the body in functioning normally and producing normal red blood cells.

• Blood Transfusion: In cases of severe anemia, a blood transfusion is required as a treatment option since the condition is caused by a sudden occurrence, such as the loss of blood due to surgery or trauma.

• Oral Iron Replacement: Oral iron treatment, ferrous iron, as iron salts are the most easily absorbed iron. Those who use oral iron supplements can develop gastrointestinal side effects such as nausea, stomach cramps, epigastric discomfort, constipation, or diarrhea. These symptoms can occur at any time throughout supplementation. The dosage may play a role in the development of certain side effects. In most cases, decreasing the dosage to one or two tablets per day and prescribing administration with meals is sufficient to decrease these adverse effects to an acceptable level. This is true even though this may lengthen the time it takes for the patient to experience a response to the medication.

• Parenteral Iron Therapy: Indications that parenteral iron therapy may be essential include the presence of micronutrient deficiencies, sensitivity to oral preparations, and iron losses that exceed levels that may be replenished with oral iron supplements.

• Vitamin B6 Supplement: Supplementing with vitamin B6 could help alleviate symptoms of depression, nerve problems, and irritability, among other conditions.

• Treatment of the Underlying Illness: The treatment for the underlying illness would consist of primary care from a physician and implementing a suitable eating plan and medication.

• Treatment of Lead Toxicity: Chelation therapy and EDTA chelation therapy are two potential treatments for lead toxicity that can be administered to patients.

• Management of Thalassemia: Blood transfusions, iron chelation, and folic acid supplements are the treatments used for thalassemia major. In addition, managing thalassemia can assist in the management of microcytic anemia.

Conclusion

A disorder known as microcytic anemia is characterized by abnormally small red blood cells compared to those seen in healthy individuals. This could result from a dietary deficiency, an inherited illness, acute or chronic bleeding, or a chronic disease with many different factors that could be responsible. The signs of the condition could be more precise. The results of the blood test will determine the diagnosis. The medication would return the red blood cells to normal levels and alleviate the symptoms.