The microcytosis It is a condition where the red blood cells in the blood are smaller than normal, measured by their mean corpuscular volume. This is expressed in a size of less than 80 microns3 (80fL) in adult patients..
Hemoglobin is essential for the transport of oxygen and carbon dioxide, therefore a patient with alterations in red blood cells may suffer a series of symptoms of fatigue, shortness of breath and exhaustion..
Macrocytosis is usually an incidental finding on a normal blood count, and patients with this condition are usually asymptomatic. It is usually a specific indicator of iron deficiency anemia, thalassemia and sideroacréstica anemia.
Alterations in the size of red blood cells, also called erythrocytes or red blood cells, is known as anisocytosis, a pathological state of red blood cells, where they have variable dimensions instead of having the same diameter. This generates the presence of red blood cells of different sizes in the same blood sample and usually occurs in patients who have received transfusions..
During life, the levels of red blood cells and hemoglobin vary and in childhood the mean corpuscular volume and corpuscular hemoglobin are lower. Then, hemoglobin levels can also be affected by tobacco use, altitude, among other factors..
Erythrocytes are recognized both by their size and by the presence of hemoglobin within them. This protein defines the color of the cells, although there is also the possibility that there are red blood cells affected with microcytosis but with a normal coloration. This is because a relatively adequate amount of hemoglobin is still kept inside the cell..
In the case of microcytosis, the red blood cells are smaller than the corpuscular volume they should have. Red blood cells can be small due to mutations in their formation, which is known as hereditary microcytosis; or it can also be associated with iron deficiencies; since red blood cells do not contain enough hemoglobin inside.
Depending on the age and gender of the patient, there are various causes of microcytosis. For example, in children and adolescents the most common are iron deficiency anemia (microcytic anemia), thalassemia, lead poisoning or lead poisoning, sideroblastic anemia or chronic inflammation.
In the case of women, it is usually due to iron deficiency anemia, thalassemia, pregnancy, sideroblastic anemia and anemia due to chronic diseases. If the woman is not menstruating, the factors are the same as those that cause microcytosis in a man, including again iron deficiency anemia, chronic disease, thalassemia, and anemia with no identified cause.
That is why the most common cause is iron deficiency anemia. In this case, microcytosis is not related to a reduction in DNA synthesis or a genetic alteration. This condition is known as microcytic anemia..
When suspecting microcytic anemia, it is essential to measure iron in the blood, through a blood ferritin test. Ferritin is the protein within cells that stores iron. The values are variable in men and women, and if they are lower than 12 nanograms per millimeter (ng / mL) it is likely that the person has iron deficiency.
This low concentration of iron in the blood can be due to a diet very low in iron, bleeding produced by wounds - both external and internal (for example bleeding inside the digestive tract: esophagus, intestines, stomach), very heavy menstruation or failure in the absorption of iron. The possibility of a gastrointestinal tumor that is causing hidden bleeding should even be considered..
However, the most likely and common cause is anemia. Although most likely it is iron deficiency anemia.
Microcytosis is usually diagnosed through a blood test and by obtaining the results, more information can be obtained on the etiology of the alteration according to the patient's report. Information about your nutrition is essential, for example, if you have cravings for ice or snacks - which corresponds to an abnormal anxiety to eat earth or other minerals, which reflects a lack of iron.
It should be investigated if the patient, due to his work or occupation, has contact with heavy metals such as lead, which could be causing poisoning and lead poisoning. It is also important to find out if your family has histories of anemia, thalassemia; or if you have suffered from chronic infections, diseases or permanent inflammatory processes.
Gastrointestinal symptoms are very relevant, bloating and abdominal pain, all kinds of gastric upset and bleeding in vomit or stools can provide information on an internal problem that leads to bleeding and therefore microcytosis.
In the case of women, the history of their menstrual periods is an indication of more or less blood loss, which can also cause anemia.
Affected patients usually suffer from these symptoms, to a greater or lesser extent depending on the severity of the anemia:
There are also other conditions that can cause microcytosis. One of them is thalassemia. Beta-thalassemia is an autosomal recessive genetic disease, in which the person does not produce enough hemoglobin, since it does not generate the protein chains necessary for the construction of hemoglobin.
The body in these patients generates an abnormal form of hemoglobin, resulting in the destruction of red cells, leading to anemia. It is a genetic condition that is passed from generation to generation and usually affects people from Southeast Asia, the Middle East, of African descent and Chinese.
Some symptoms of those who suffer from this disease are deformations in the bones of the face, growth failure, dyspnea (shortness of breath), habitual fatigue and yellow skin (jaundice). People who have the minor form of thalassemia are those with microcytosis but without these symptoms associated with their disease.
On the other hand, microcytic anemia can also be caused by thalassemia or iron deficiency in the blood. There are five main causes that in English form the acronym TAILS. These are thalassemia, anemia of chronic disease, iron deficiency, congenital sideroblastic anemia, and lead poisoning (lead poisoning). Each of these causes can be ruled out with more blood tests, where microcytosis is just one of the abnormalities that cells present..
In the case of microcytic anemia, the small red blood cells with insufficient hemoglobin do not have the ability to carry enough oxygen throughout the body. This produces symptoms such as lack of appetite, general paleness, brittle nails, dry mouth, among others..
Depending on the severity of the anemia, the patient may be asymptomatic or have various variations of fatigue, dizziness, and dyspnea..
Nutritional deficiency is undoubtedly the major cause of microcytic anemia, especially in children. In the case of women, the predominant factor turns out to be very abundant blood losses during menstruation. In adult men and women who do not menstruate, it is worth expanding the studies in the case of the possibility of hidden bleeding, as they occur in tumors or other pathologies of the gastrointestinal area (gastritis, esophagitis, ulcers, celiac disease, among others).
Another cause of microcytosis is anemia from chronic diseases. This occurs when there are chronic inflammatory processes or infections. In these cases, increased levels of cytokines cause a decrease in the production of erythropoietin, which interferes with iron metabolism. Some of these anemias have features of microcytosis. Their prognosis is favorable and they are not progressive.
In general, the treatment of microcytosis consists of increasing the intake of iron in the diet, in order to restore the adequate levels of hemoglobin and increase the size of the red blood cells..
Iron enters the body through the foods we eat, dairy products, soy protein, and meats. Other non-animal sources of iron include lentils, whole grain products, dried fruits, and beans..
To increase the absorption of iron in the diet, it is recommended to mix it with products that contain vitamin C such as berries, citrus fruits, tomatoes and melons. Foods rich in calcium - such as dairy - interfere with the absorption of iron, so it is recommended to consume them separately if the goal is to increase iron levels in the body.
If a greater increase in iron in the body is necessary, supplements may be considered. The recommended dose is 60 milligrams (mg) of iron once or twice a day. Ideally, iron capsules should be taken alone, so that no other element influences its absorption. In addition, taking 500 mg daily of ascorbic acid - vitamin C - together with the iron supplement promotes greater beneficial effects.
Treatment with iron supplements is generally effective against anemia. However, in patients who do not respond to these measures or have recurrent anemia, further studies are required to identify the cause that continues to provoke it..
In rare cases, blood transfusion is used to treat iron deficiency anemia. This treatment is usually used in hospitalized patients with cardiovascular diseases who have a hemoglobin threshold of less than 7-8 ng / mL..
Basically, microcytosis can be prevented and treated with an increase in iron intake in food, either through foods containing iron or external supplements. If anemia does not improve, we recommend seeking medical help.
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