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Anemia in the Adult Patient

Source: www.turner-white.com
Topic: Anemia
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Sort Desciption: typically defined as a hemoglobin level of less than 13.0 g/dL in males and 12.0 g/dL in females, 1 is an indication of either dietary deficiency or an underlying pathologic process or disease. ...

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Anemia in the Adult Patient anemia, typically defined as a hemoglobin level of less than 13.0 g/dL in males and 12.0 g/dL in females, 1 is an indication of either dietary deficiency or an underlying pathologic process or disease. Iron deficiency, the most common nutritional deficiency in the world, is the most common cause of anemia. 2 4 Iron deficiency anemia is most prevalent among women of childbearing age and is more common in developing countries. Iron deficiency anemia can result either from nutritional deficiency or chronic blood loss. Other causes of anemia include chronic disease, renal failure, hemolysis, bone marrow disorders, and vitamin deficiencies. This article discusses the signs and symptoms associated with anemia in adults and reviews the laboratory evaluation of anemia, which is important in differentiating underlying causes. ILLUSTRATIVE CASE A 73-year-old man presents with a 3-week history of fatigue and dyspnea. He also reports episodes of melena (the passage of black or tarry stools) for the past 3 weeks. On physical examination, the patient appears pale but is in no apparent distress. His blood pressure is 100/50 mm Hg and his pulse is 110 bpm. The eye examination is remarkable for pale conjunctivae (Figure 1 ). The heart examination reveals regular rhythm with a systolic ejection murmur. The lungs are clear to auscultation. Epigastric tenderness is noted, and a stool sample is guaiac-positive. Laboratory examination reveals a blood hemoglobin level of 5 g/dL with a mean corpuscular volume (MCV) of 87 fl. SYMPTOMS AND SIGNS OF ANEMIA Table 1 lists items to consider in taking the history and performing the physical examination of a patient who may have anemia. Patients with anemia may present with fatigue, dizziness, and dyspnea; however, mild anemia may produce little in the way of clinical signs and symptoms. In the presence of congestive heart failure, mild anemia can worsen the dyspnea associated with the heart failure, and in patients wit ...

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