THE VARIED CAUSES OF ANAEMIA
Pernicious anaemia
The person with pernicious anaemia has all the symptoms of anaemia that I have described. In addition, the skin is a pale-yellow, lemon colour. The tongue is sore and reddened. There may be difficulty in swallowing. There are changes in the nerves and spinal cord, which frequently produce the sensation of ‘pins and needles’ in the fingers and toes. The gait may be unsteady.
The reaction to treatment of pernicious anaemia is quickly evident. When injections of vitamin B12 are given to persons with this severe anaemia, there is dramatic improvement. The blood becomes normal again. The pallor, weakness, and shortness of breath disappear. Usually, the symptoms attributable to the nerves and spinal cord are improved, too. However, it must be remembered that these medicines cannot cure pernicious anaemia. They merely replace some substance the body lacks to make normal red blood cells. Therefore, treatment must be continued regularly and throughout life in order to control the anaemia and symptoms.
Anaemias caused by destroyed or deformed red blood cells
•Anaemia can also be caused by the destruction of red blood cells. These are referred to as haemolytic anaemias. Some of them are congenital in type, others are acquired; some are chronic, others acute. They differ from other anaemias, too, in that jaundice may be present, because the destroyed red cells release their haemoglobin, and it is converted into the jaundice pigments.
Sickle-cell anaemia is a serious, inherited form of anaemia that appears almost entirely in Negroes. The malady is so named because of the shape of the person’s red blood cells.
Anaemias caused by impairment of the bone marrow
The red blood cells are manufactured chiefly in the red marrow of the long bones, the sternum (breastbone), and the vertebrae. Any disease process, chemical, or radio-active substance that invades, destroys, or depresses the activity of the bone marrow can lead to anaemia.
This bone-marrow illness is also called aplastic anaemia; in it, the blood platelets and the white cells are also damaged. There will usually be other symptoms besides those of anaemia. Bleeding from the nose and mouth and black-and-blue spots on the skin occur frequently. Infections and fever may accompany the debilitation following aplastic anaemia. It is a serious condition and should be treated in a hospital.
Miscellaneous anaemias
There are many anaemias that arise in the course of other diseases. For example, in chronic kidney disease, there is usually a severe and persistent anaemia; in hypothyroidism or myxoedema, anaemia may be persistent until thyroid medication is given; sprue may be accompanied by anaemia; intestinal parasites cause various kinds of anaemia.
Mediterranean anaemia is found in people living in the Mediterranean area, or in their descendants who have migrated to other countries. This inherited form of anaemia is also called Cooley’s anaemia and thalassaemia. It may be a severe, fatal disease in young children. In others, the disease is compatible with a long adult life.
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