Ahmed Reda: Your Red Blood Cell Can Tell a Story – Not All Anemia Looks the Same
Ahmed Reda, Certified Veterans Affairs(VA) provider for C&P exams at Veterans Evaluation Services, shared a post on LinkedIn:
“Your red blood cell can tell a story
Not all anemia looks the same.
The size, shape, color, and number of red blood cells can provide important clues about what is happening inside the body.
Normal red blood cells
Normal RBCs are flexible, biconcave discs.
This shape increases the surface area available for oxygen exchange and allows the cells to pass through tiny capillaries.
Hemoglobin gives them their red color and carries oxygen from the lungs to tissues.
Anemia
Anemia means reduced hemoglobin concentration or red-cell mass.
The result can be reduced oxygen delivery to tissues. Common symptoms include Fatigue Shortness of breath Palpitations Dizziness Pallor Headache
Why is the patient anemic?
Iron deficiency anemia:
Red cells often become smaller and contain less hemoglobin.
Typical pattern
Microcytic and hypochromic RBCs
Possible causes include
- Chronic blood loss
- Inadequate iron intake
- Impaired iron absorption
- Increased iron requirements
Typical laboratory clues include low ferritin and low transferrin saturation.
Megaloblastic anemia:
Red blood cells become larger because DNA synthesis is impaired.
Typical pattern
Macrocytosis with macro-ovalocytes and hypersegmented neutrophils
Common causes include
- Folate deficiency
- Vitamin B12 deficiency
- Pernicious anemia
- Certain medications
Vitamin B12 deficiency deserves attention because it may also cause
- Numbness and tingling
- Balance problems
- Cognitive or neurological changes
Sickle cell anemia
This is an inherited hemoglobin disorder involving hemoglobin S.
Under conditions such as hypoxia, dehydration, or acidosis, HbS can polymerize.
The red cells become rigid and may develop the characteristic sickle shape.
This can cause
- Hemolytic anemia
- Painful vaso-occlusive crises
- Acute chest syndrome
- Stroke
- Increased susceptibility to some infections
The CBC gives us the first clue
MCV helps classify anemia.
- Low MCV- think microcytic anemia
- Normal MCV – think normocytic anemia
- High MCV – think macrocytic anemia
Then combine the CBC with the clinical history, reticulocyte count, peripheral blood smear, iron studies, vitamin B12, folate, and other tests when indicated.
‘Why is the hemoglobin low?’
That question changes anemia from a laboratory number into a diagnosis.”
Proceed to the video attached to the post.
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