Classification and diagnostic criteria of anemia

Anemia is a very common problem, especially for women, where it is more likely to occur. There are certain diagnostic criteria for whether anemia is mild or severe. According to these different criteria, anemia can be divided into different types. Different types of anemia require different methods of treatment and physical conditioning. Below we will introduce the diagnostic criteria and classification methods of anemia.

1. Diagnostic Criteria

According to my country's standards, hemoglobin measurement values ​​are: lower than 120g/L for adult males and lower than 110g/L for adult females, and their hematocrit values ​​are lower than 0.42 and 0.37 respectively, which can be diagnosed as anemia.

2. Classification

1. Classification based on etiology and pathogenesis

(1) Decreased red blood cell production

① Abnormal proliferation and differentiation of stem cells:

Hematopoietic stem cells: aplastic anemia, Fanconi anemia.

Erythroid progenitor cells: pure red cell aplasia, anemia caused by renal failure.

② Cell differentiation and maturation disorders:

DNA synthesis disorders: Vitamin B12 deficiency, folate deficiency, defects in purine and pyrimidine metabolism (megaloblastic anemia).

Hb synthesis defects: heme synthesis defects (iron deficiency anemia and sideroblastic anemia), globin synthesis defects (thalassemia).

③Unknown causes or multiple mechanisms: bone marrow infiltrative anemia, anemia of chronic disease.

(2) Excessive destruction of red blood cells

① Endogenous:

Red cell membrane abnormalities: hereditary spherocytosis, hereditary elliptocytosis.

Erythrocyte enzyme abnormalities: glucose-6-phosphate dehydrogenase deficiency, pyruvate kinase deficiency.

Abnormal globin synthesis: sickle cell anemia, other hemoglobinopathies.

②Exogenous:

Mechanical: march hemoglobinuria, prosthetic heart valve hemolytic anemia, microangiopathic hemolytic anemia.

Chemical, physical or microbiological factors: chemical poison and drug-induced hemolysis, extensive burns, infectious hemolysis.

Immune: autoimmune hemolytic anemia, neonatal alloimmune hemolytic disease, drug-induced hemolytic anemia.

Increased destruction of the monocyte-macrophage system: hypersplenism.

(3) Hemorrhagic anemia: acute hemorrhagic anemia and chronic hemorrhagic anemia.

2. Classification based on cell morphology

3. Classification according to the degree of myeloproliferation

(1) Proliferative anemia: such as hemolytic anemia, hemorrhagic anemia, megaloblastic anemia and iron deficiency anemia.

(2) Hypoplastic anemia: such as aplastic anemia.

3. Treatment Methods

In emergency situations, patients with severe anemia, the elderly, or anemia patients with cardiopulmonary insufficiency should receive red blood cell transfusions to correct anemia and improve the body's hypoxia. However, blood transfusion is only a temporary treatment measure. Repeated blood transfusions may lead to hemochromatosis, which requires iron removal treatment. Therefore, it is most important to find the cause and provide targeted treatment.

Usually, anemia is just a symptom, not a single disease. Therefore, the underlying cause needs to be determined before effective treatment can be carried out. Patients with acute massive blood loss should actively stop bleeding, while quickly restoring blood volume and transfusing red blood cells to correct anemia. Nutritional anemia can be treated by supplementing the missing nutrients, such as iron supplementation for iron deficiency anemia and treatment of the primary disease that causes iron deficiency; and folic acid or vitamin B12 supplementation for megaloblastic anemia.

The treatment of non-nutritional anemia is more complicated. Autoimmune hemolytic anemia is mainly treated with immunosuppressants such as glucocorticoids. Chronic aplastic anemia is mainly treated with cyclosporine combined with androgens. For example, inherited anemias such as Fanconi anemia can be treated with hematopoietic stem cell transplantation.