Hca_240_Blood_Disorders

Amy, a 4-year-old Caucasian female, has been complaining of being tired all the time. She is pale and a picky eater. Her mother is a single mom with a small budget to feed a large family. Amy only eats pasta, breads, and hot dogs, and drinks only artificial fruit punch. This is a case of iron deficiency anemia. Anemia is a condition that develops when your blood lacks enough healthy red blood cells. These cells are the main transporters of oxygen to organs. If red blood cells are also deficient in hemoglobin, then your body isn't getting enough oxygen. Symptoms of anemia -- like fatigue -- occur because organs aren't getting enough oxygen. (WebMD) Iron deficiency anemia is a decrease in the number of red blood cells, caused by a lack of sufficient iron. Alternative Names: Anemia - iron deficiency - children Causes, incidence, and risk factors: Iron deficiency anemia is the most common form of anemia. Iron is an essential component of hemoglobin, the oxygen-carrying protein in blood. Iron is normally obtained in the diet and by the recycling of iron from old red blood cells. (Dr. Koop) Babies are born with about 500mg of iron in their bodies. By the time they reach adulthood they need to have accumulated about 5000mg. Children need to absorb an average of 1mg per day of iron to keep up with the needs of their growing bodies. Since children only absorb about 10% of the iron they eat, most children need to ingest 8-10mg of iron per day. Breast-fed babies need less, because iron is absorbed 3 times better when it is in breast milk. An iron deficient diet is a common cause of iron deficiency. Drinking too much cow's milk is a classic cause of iron deficiency in young children, because cows’ milk does not contain iron and inhibits absorption of iron. Iron deficiency may also result from blood loss in stool from a problem in the intestines. A common time for iron deficiency is between 9 and 24 months of age. All babies should have a screening test for iron deficiency at this age. Babies born prematurely may need to be tested earlier. The adolescent growth spurt is another high-risk period. (Dr. Koop) Treatment for iron-deficiency anemia will depend on the cause and severity of the condition. Treatments may include dietary changes and supplements, medicines, and surgery. Severe iron-deficiency anemia may require treatment in a hospital, blood transfusions, iron injections, or intravenous (IV) iron therapy. The goals of treating iron-deficiency anemia are to treat its underlying cause and restore normal levels of red blood cells, hemoglobin, and iron. (National Heart Lung and Blood Institute) Marcus is a 5-year-old African-American male who has just moved to New York City, and is visiting his new pediatrician for a kindergarten physical. His mom tells the nurse that she carries the “trait” and wants Marcus screened for it. This is a disorder is called Thalassemia. Thalassemia (say "thal-uh-SEE-mee-uh") is an inherited blood disorder that causes your body to make less hemoglobin. Hemoglobin helps red blood cells spread oxygen through your body. Low levels of hemoglobin may cause anemia, an illness that makes you feel weak and tired. Severe anemia can damage organs and lead to death. (WebMd) Hemoglobin contains two chains, alpha and beta globin. Genetic defects may be inherited that cause an imbalance in the production of either chain. Beta thalassemias are caused by a mutation in the beta globin chain. Genes must be inherited from both parents to acquire the major form of this disease. If one gene is inherited, the person will be a carrier of the disease, but will not have symptoms. This is the minor form of the disease. In the major form, children are normal at birth, but develop anemia during the first year of life. Growth failure, bone deformities, and enlarged liver and spleen are some of the problems that can occur. Blood transfusions may modify some of the disease manifestation, but iron overload from the transfusions may cause damage to the heart, liver, and endocrine systems. The mild form of beta thalassemia produces small red blood cells, with no symptoms. Risk factors include a family history of thalassemia and an ethnic background that has shown susceptibility to the disease. Beta Thalassemia occurs in people of Mediterranean origin, and to a lesser extent, Chinese, other Asians, and blacks. Alpha Thalassemia occurs most commonly in people from Southeast Asia and China, and is caused by deletion of a gene or genes from the alpha globin chain. The most severe form of alpha thalassemia causes stillbirth (death of a fetus before delivery). (Dr Koop) Treatments for Thalassemia depend on the type and severity of the disorder. People who are carriers or who have alpha or beta thalassemia trait have mild or no symptoms. They need little or no treatment. Doctors use three standard treatments for moderate and severe forms of thalassemia. These include blood transfusions, iron chelation (ke-LAY-shun) therapy, and folic acid supplements. Other treatments have been developed or are being tested, but they're used much less often. (National Heart Lung and Blood Institute) Richard has noted over the past several weeks that he is having more bruises, or ecchymosis, all over his body. After coughing this morning, he noticed tiny red marks all around his eyes. This disorder is called purpura simplex. Aside from the common bruise, bleeding into the skin or mucous membranes is a very significant sign and should always be evaluated. Bleeding that consists of pinpoint dots of blood is called petechiae. Larger flat areas where blood has collected under the tissue, up to a centimeter in diameter, are called purpura. A very large area is called an ecchymosis. Redness of the skin (erythema) should not be mistaken for bleeding. Petechiae, purpura, and ecchymosis do not blanch (become pale) with pressure, while the redness of erythema decreases and then returns when pressure is applied and released. Common Causes: Injury or trauma Allergic reaction Autoimmune disorders Viral infection or illness affecting blood coagulation Thrombocytopenia Medical treatment, including radiation and chemotherapy Antiplatelet medications such as clopidogrel (Plavix) Bruise (ecchymosis) Birth (petechiae in the newborn) Aging skin (ecchymosis) Idiopathic thrombocytopenic purpura (petechiae and purpura) Henoch-Schonlein purpura (purpura) Leukemia (purpura and ecchymosis) Drugs o Anticoagulants such as warfarin or heparin (ecchymosis) o Aspirin (ecchymosis) o Steroids (ecchymosis) Septicemia (petechiae, purpura, ecchymosis)(Dr Koop) Thrombotic thrombocytopenic purpura (TTP) is a rare blood condition. It causes blood clots to form in small blood vessels throughout the body. The blood clots can cause serious problems if they block the blood vessels and limit blood flow to the brain, kidneys, or heart. Thrombotic thrombocytopenic purpura (TTP) can be fatal or cause lasting damage, such as brain damage or stroke, if it's not treated promptly. In most cases, TTP occurs suddenly and lasts for days or weeks, but it can go on for months. Relapses (flareups) can occur in up to 60 percent of people who have the acquired type of TTP. Flareups also occur in most people who have inherited TTP. Plasma treatments are the most common way to treat TTP. Other treatments include medicines and surgery. Treatments are done in a hospital. (National Heart Lung and Blood Institute)   References Dr Koop (2009). Health central. Blood disorders. Retrieved from: http://www.drkoop.com National Heart Lung and Blood Institute (2010) Blood disorders. Retrieved from: http://www.nhlbi.nih.gov/health/dci/Diseases/ttp/TTP_Treatments.html WebMD (2010). Blood Disorders. Retrieved from: http://www.webmd.com