Case study- Anemia
Given the description of the given, the patient has Anemia. Since the peripheral blood film indicates the Red blood cells that are microcytic and hypochromic. This suggests that the patient has microcytic hypochromic anemia. The hemoglobin concentration of the Ms. Green is 8g/dL upon examination which clearly shows a reduction in the hemoglobin concentration concerning the age and sex. According to her age and sex, the normal hemoglobin concentration should range between 11.5g/dL to 13.5g/dL. Ms. Green is therefore anemic as portrayed by a reduction in the hemoglobin concentration.
Microcytic hypochromic anemia present in the blood smear is termed as so because the Red blood cells are smaller than the expected normal size. In the blood film, they are smaller than the lymphocytes which are used to assess the size of the Red blood cells. The degree of hemoglobinization is also affected in the Red blood cell. The Red blood cells appear pale than the typical Red blood cells. The fact behind this is that the red blood cells have the fewer amount of hemoglobin that what is expected as a result of impaired hemoglobin formation in microcytic hypochromic anemia. The blood film also indicates the presence of the target cells and pencil poikilocytes that are evidence for microcytic hypochromic anemia.
Ms. Green develops microcytic hypochromic anemia as a result of iron deficiency. Usually, Iron is an essential factor in the formation of the red blood cells mainly in the formation of the hemoglobin. Therefore when the iron is decreased in the supply about body demands, the individual has impaired hemoglobin formation and thus develops cells that are small and hypochromatic just as what Blood film indicates. Iron deficiency in Ms. Green stems from the inability to take in enough iron as the body demands. The diet consumed could be less of the iron and thus lead to less iron absorption that is not able to meet the body demands. As a result of this, Ms. Green can complain of the shortness of breath and loss of energy and enthusiasm. Similarly, the iron absorption could be the problem. The diet could be as well rich in the iron, but the intake is hindered by the absence of the intrinsic factor produced by the parietal cells in the stomach. Other factors that cause malabsorption of iron could be Gluten-induced enteropathy, gastrectomy, autoimmune gastritis and infection by Helicobacter pylori.
Ms. Green complains that the symptoms are even worse during her menses. Menstruation is an important factor that affects iron demand among the women in the reproductive age that Ms. Green also belongs in. The loss of blood in the Menses also causes loss of the iron in the body. Therefore, more iron intake should be done to replace the lost blood and form new red blood cells. Given that Ms. Green has already microcytic hypochromic anemia with less iron, the menses cause even more loss of blood and iron that lead to severe symptoms. The reticulocytes in the blood are within the normal range of 0.5%-2%.
Owing to low hemoglobin, Ms. Green is unable to sufficiently supply oxygen demands to the body tissues since hemoglobin is essential in the body for oxygen delivery to every tissue in the body including the brain. To compensate for the reduced oxygen-carrying capacity, Ms. Green experiences elevated heart rate to pump as much blood as possible to tissues. Shortness of breath is attributive to high body demand for oxygen. The reduce energy is due to the reduced oxygenation of the tissues. Oxygen is vital in the energy production and thus is reduced if the oxygen supply is jeopardized by the anemia.
Conclusion
Ms. Green have microcytic hypochromic anemia that is due to the iron deficiency. The symptoms arise as a result of the decreased oxygen delivery to the tissues in the body. The loss of blood during menstruation potentiates the anemia leading to even worse and severe symptoms due to loss of blood volume as well as more irons. Being a woman in reproductive age, menstruation dramatically increases the iron demands that if not well adhered to can readily precipitate microcytic hypochromic anemia due to iron deficiency.
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