What is anemia?

From the Guidelines

Anemia is defined as a decreased red blood cell mass or hemoglobin concentration, with the World Health Organization defining it based on hemoglobin concentrations, specifically for women ≥ 15 years old, as mild anemia with a hemoglobin 11.0–11.9 ng dL −1, moderate anemia with a hemoglobin 8.0–10.9 ng dL −1, and severe anemia with a hemoglobin < 8.0 ng dL −1 1.

Key Characteristics of Anemia

• Decreased red blood cell mass or hemoglobin concentration
• Defined by the World Health Organization based on hemoglobin concentrations
• Categories of anemia include mild, moderate, and severe, based on hemoglobin levels

Causes and Risk Factors

• Iron deficiency is a common cause of anemia, but it is not synonymous with anemia
• Other causes include vitamin deficiencies (B12 or folate), chronic diseases, inherited blood disorders, and blood loss
• Female athletes with restrictive diets, high amounts of repetitive ground strikes, endurance training, and heavy menstrual bleeding are at higher risk for iron deficiency and anemia 1

Diagnosis and Treatment

• Diagnosis involves a full iron panel, including a complete blood count with reticulocyte count, ferritin, serum iron, transferrin, transferrin saturation, and total iron binding capacity
• Treatment depends on the underlying cause, but may include dietary changes to increase iron intake, iron supplements, vitamin B12 injections, or folate supplements 1

Importance of Accurate Diagnosis

• It is possible for an athlete to be iron deficient but not anemic, or to have "pseudoanemia" where iron studies indicate anemia but the laboratory values are a result of expanded plasma volume 1
• Accurate diagnosis and treatment are crucial to improve symptoms and quality of life, particularly in female athletes who are at higher risk for iron deficiency and anemia.

From the FDA Drug Label

Anemia Due to Chronic Kidney Disease PROCRIT is indicated for the treatment of anemia due to chronic kidney disease (CKD), including patients on dialysis and not on dialysis to decrease the need for red blood cell (RBC) transfusion. Anemia Due to Zidovudine in Patients with HIV Infection PROCRIT is indicated for the treatment of anemia due to zidovudine administered at ≤ 4200 mg/week in patients with HIV Infection with endogenous serum erythropoietin levels of ≤ 500 mUnits/mL. Anemia Due to Chemotherapy in Patients with Cancer PROCRIT is indicated for the treatment of anemia in patients with non-myeloid malignancies where anemia is due to the effect of concomitant myelosuppressive chemotherapy, and upon initiation, there is a minimum of two additional months of planned chemotherapy.

Anemia is a condition characterized by a decrease in the number of red blood cells (RBC) or the amount of hemoglobin in the blood. It can be caused by various factors, including:

• Chronic kidney disease (CKD): Anemia is a common complication of CKD, where the kidneys are unable to produce enough erythropoietin, a hormone that stimulates the production of RBC.
• Zidovudine administration in HIV infection: Anemia can occur in patients with HIV infection who are taking zidovudine, a medication used to treat HIV.
• Chemotherapy in cancer patients: Anemia can be a side effect of chemotherapy, particularly in patients with non-myeloid malignancies. 2

From the Research

Definition of Anemia

• Anemia is a condition characterized by a decrease in the amount of iron in the body, leading to hypochromic anemia and poor hemoglobin synthesis 3.
• It can be caused by insufficient intake of iron-rich foods, increased necessities during growth period, pregnancy, erythrocytes hyperregeneration, high-performance sportsmen, increased loss by digestive way, genito-urinary way, respiratory, hemorrhagic syndromes 3.

Types of Anemia

• Iron-deficiency anemia is the most frequent pathology, and its treatment involves oral iron supplementation 4.
• Vitamin B12 and folate deficiencies can also cause anemia, and their levels can increase during treatment of iron deficiency anemia 5.
• Anemia can be classified into different types, including iron deficiency anemia, vitamin B12 deficiency anemia, and folic acid deficiency anemia 6.

Prevalence of Anemia

• The prevalence of anemia is common among older people, with a prevalence of 7.3% found in a study of community dwelling elderly in Ankara, Turkey 6.
• Iron deficiency, vitamin B12, and folic acid deficiencies are also common, with prevalence rates of 7.1%, 64.2%, and 10.9%, respectively 6.
• Anemia can have significant clinical implications, including symptoms such as atrophic glositis, angular stomatitis, sideropenic dysphagia, pica, skin and nails changes 3.

Diagnosis and Treatment

• Laboratory investigations useful for diagnosis include microcytic, hypochromic anemia, decreased serum iron level, total capacity of iron binding increased, medullar iron store absent, good response to iron therapy 3.
• Treatment of iron deficiency anemia typically involves oral iron supplementation, with ferrous sulfate being the simplest, least expensive, and most commonly prescribed drug 4, 7.