Wk 7 Anemia- patho
Anemia
This discussion will cover an overview of folate deficiency anemia. The pathophysiology will be reviewed along with the similarities and differences between folate deficiency anemia and iron deficiency anemia. Patient factors will be discussed and how they impact these types of anemic disorders.
Folate Deficiency Anemia
First, folate is a vitamin the body uses for RNA and DNA synthesis that helps erythrocytes mature. Folate helps to process thymine and purines. If folate levels are low, the synthesis and replications of DNA slows, and cell replication cannot be completed. Folate absorption is processed in the small intestine and does not require other vitamins for absorption (Huether & McCance, 2017). Those with folate deficiency anemia present with cheilosis or scales and fissures of the mouth and tongue, and stomatitis. Other disorders can exacerbate this disorder such as absorption disorders and gastrointestinal disorders. Thiamine deficiency commonly accompanies a folate deficiency which can create neurological complications (Sukla, Nagar, & Raman, 2014)
Similarities and Differences
Iron deficiency anemia occurs commonly around the world (Hammer & McPhee, 2014). A similarity between folate and iron deficiency anemia is that many that are malnourished will have both disorders. Vitamin B-12 with thiamine and folate contribute directly to curb the effects of anemia. Without these vitamins to synthesize, anemia will be present. They seemingly work together as a team (Sukla, Nagar, & Raman, 2014). Furthermore, children are commonly affected, although; iron deficiency anemia has seen an increase in children that are obese. Differences in each include iron deficiency directly affects hemoglobin synthesis and can be caused from blood loss (Cadet, 2014). Folate deficiency is commonly due to poor dietary intake or absorption disorders. For the most part, folate deficiency anemia is not complicated to treat. Once blood tests are obtained with a folate measure oral folate is provided. Blood levels are monitored and once it is at an acceptable level oral folate can be stopped if dietary folate is adequate. This is estimated at one to two weeks. On the other hand, iron deficiency anemia slowly develops, and the effects can be permanent (Huether & McCance, 2017).
Patient Factors
Patient factors that can contribute to both anemias are age and behavior. Many young children are affected due to poor nutrient intake. This is due to poor living conditions, poverty, picky eating, and poor immune function (Cadet, 2018). Behavior plays a part at any age. Children without the supplemented nutrients or the means to get them are at a disadvantage. Iron deficiency anemia is common among countries with a high poverty rate. Children in these countries are malnourished with other conditions and or adverse environmental conditions that can exacerbate this type of anemia such as parasitic infections (Huether & McCance, 2017). One the other hand, folate deficiency anemia occurs most commonly in alcoholics and those that are chronically malnourished. This is caused since folate is absorbed in the small intestine and is stored in the liver (Sukla, Nagar, & Raman, 2014). Behaviors can have an adverse impact causing more complications.
Anthony,
That was a very good discussion explaining the principles behind pernicious anemia. Pernicious anemia used to be fatal. Hence, the word pernicious means damaging and destructive (Heuther & McCance, 2017). It slowly progresses, normally taking twenty to thirty years to present issues. Skin color of those with pernicious anemia tend to be sallow or lemon-yellow color. This type of anemia usually affects mostly adults over the age of thirty and are of Northern European descent (Huether & McCance, 2017), although; genetically this type of anemia has shown a link within families. Treatments that have shown promise are oral vitamin B12 because it can be absorbed over the small bowel. Nowadays, individuals rarely die unless they are not complaint with treatments (Gilbert, 2017). There is new evidence that examines the possibility of pernicious anemia resulting in hyperhomocysteinemia which can lead to thrombosis without any other comorbidity. Those individuals are treated with vitamin B12 cobalamin supplementation (Ammouri, Tazi, Harmouche, Maamar, Adnaoui, & Tazi, 2017)..
Jennifer,
Your discussion was very interesting and to the point! Hematology is interesting because a lot of ailments can relate and be treated due to a deficiency in the blood. It is a vast component of our bodies that needs the right factors to function. Sometimes a big issue such as pernicious anemia can be solved with diet modification and vitamin B12 (Huether & McCance, 2017). Many patients require more education about blood, it’s components and how it really works and directs other functions in the body. This reinforcement helps communities identify the prevalence of certain disorders and helps healthcare workers identify populations that need more resources and treatments specific to their needs. For example, tinnitus in the elderly is linked to anemia and only certain anemias (Sunwoo et al., 2018) Many different disorders can be linked to different aspects and dysfunctions within the body. Finding the primary cause is the main goal.
References
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.) St. Louis, MO: Mosby.
Sunwoo, W., Lee, D. Y., Lee, J. Y., Lee, M., Kang, Y., Park, M.-H., & Kim, Y. H. (2018). Characteristics of tinnitus found in anemia patients and analysis of population-based survey. Auris Nasus Larynx, 45, 1152–1158. https://doi-org.ezp.waldenulibrary.org/10.1016/j.anl.2018.04.001
Ammouri, W., Tazi, Z., Harmouche, H., Maamar, M., Adnaoui, M., & Tazi, Z. M. (2017). Venous thromboembolism and hyperhomocysteinemia as first manifestation of pernicious anemia: a case series. Journal of Medical Case Reports, 11(1), 1–5. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.1186/s13256-017-1415-z
Gilbert, L. (2017). Diagnosis and treatment of pernicious anaemia. Practice Nurse, 47(4), 20–23. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=122680895&site=eds-live&scope=site
Cadet, M. J. (2018). Iron deficiency anemia: A clinical case study. MEDSURG Nursing, 27(2), 108–120. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=129092743&site=eds-live&scope=site
Hammer, G. G., & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.
Sukla, K. K., Nagar, R., & Raman, R. (2014). Vitamin-B12 and folate deficiency, major contributing factors for anemia: A population based study. E-SPEN Journal, 9(1), e45. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edo&AN=94152834&site=eds-live&scope=site
• Select one of the following types of anemia: pernicious anemia, folate deficiency anemia, sideroblastic anemia, chronic inflammation anemia, or post-hemorrhagic anemia. Identify the pathophysiological mechanisms of the anemia you selected.
• Consider the similarities and differences between iron deficiency anemia and the type of anemia you selected.
• Reflect on how patient factors such as genetics, gender, ethnicity, age, and behavior might impact these anemic disorders.
