Normocytic Anemia – Red Blood Cell Pathology (RBC)

Aplastic anemia (AA) is a rare, life-threatening condition characterized by pancytopenia and hypocellularity of the bone marrow (in the absence of any abnormal cells) reflecting damage to hematopoietic stem cells. Aplastic anemia can be acquired or inherited, however, most cases of AA are acquired and caused by autoimmune damage to hematopoietic stem cells. Specifically known acquired causes and associations of AAs include medications, chemicals, high doses of whole-body radiation, viral infections, immune diseases, and pregnancy. Inherited or constitutional syndromes associated with AA include Fanconi anemia, dyskeratosis congenita, and Down syndrome. Therapies include transfusion support, immunosuppression, and bone marrow transplantation.

Acute blood loss is the leading cause of acute anemia. Damage to blood vessels due to several etiology results in disruption of integrity of blood vessel leading to blood loss. It is of two types, internal and external bleeding. Internal bleeding may not easily diagnosed in many cases because of bleeding inside organs, which may result in hematoma formation. External bleeding occurs through skin from injuries and wounds. Acute blood loss usually requires  emergent surgical interventions to avoid further complications.

Anemia is a condition in which individuals have low Hb levels, which can arise from  various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia may occur from blood loss, decreased RBC production such as in iron deficiency, or increased RBC destruction such as in hemolysis. Management is aimed at improving Hb levels and treating the underlying conditions.