Anaemia: Presenting Problems in Blood Disease

Anaemia

• Anaemia is defined as a haemoglobin (Hb) level below the reference range for age and sex.
• Other factors, such as pregnancy and altitude, can affect Hb levels.
• Clinical features of anaemia result from diminished oxygen supply to the tissues.
• Symptoms are more severe if the onset is rapid or if there is coexisting cardiorespiratory disease.
• Non-specific symptoms and signs include:
  • Tiredness
  • Lightheadedness
  • Breathlessness
  • Worsening of coexisting disease (e.g. angina)
  • Mucous membrane pallor
  • Tachypnoea
  • Raised JVP
  • Flow murmurs
  • Ankle oedema
  • Postural hypotension
  • Tachycardia

Clinical Assessment of Anaemia

• Iron deficiency anaemia is the most common type of anaemia worldwide.
• Assess for symptoms indicating GI blood loss and menorrhagia in females.
• Dietary history should assess intake of iron and folate, which may be deficient in:
  • Pregnancy
  • Rapid growth
• Past medical history may reveal disease associated with anaemia (e.g. rheumatoid arthritis) or previous surgery (e.g. stomach or small bowel resection).
• Family history may be relevant in haemolytic anaemias and pernicious anaemia.
• Drug history may indicate blood loss (e.g. NSAIDs) or haemolysis or aplasia.