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Microcytic Anemia: Symptoms, Causes, Risk Factors, Treatment, And Prevention

Microcytic Anaemia (MA) is a term that is used to describe a condition in which the oxygen requirement by the body organs are not met due to smaller sized red blood cells [1] .

The condition arises when the body is unable to make an adequate amount of haemoglobin due to deficiency of iron in the body. Also, haemoglobin is a protein that helps in transporting oxygen to the bloodstream. Such condition causes bone marrow to make small-sized RBC than the normal range [2] . When the size of the RBCs decreases, the amount of oxygen in it also becomes low resulting in poor oxygen supply to the body organs, causing Microcytic Anaemia.

Symptoms Of Microcytic Anaemia

In MA, symptoms usually appear late. When the small red blood cells start affecting the tissues, it causes the following symptoms:

  • Tiredness or fatigue
  • Dizziness
  • Pale skin (especially inside the eyelids and nails) [3]
  • Loss of stamina
  • Breathing issues
  • Increased heart rate
  • Irritability
  • Pica, an eating disorder in which a person gets a desire to eat things like hair and dirt [4] .

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Causes Of Microcytic Anaemia

MA is caused due to one or more reasons depending on the amount of haemoglobin present in the red blood cells. According to the International Journal of Laboratory Hematology, the causes of MA usually form an acronym TAILS which stand for the following:

  • Thalassemia: An inherited blood disorder in which the body is unable to make enough haemoglobin causing MA [5] .
  • Anaemia of chronic disease: A condition in which the body is unable to process iron due to some underlying chronic diseases like cancer, kidney diseases, diabetes, etc [6] .
  • Iron deficiency anaemia: A condition caused due to the lack of iron in a person's body based on their age and sex. For example, women of menstruating age usually suffer from this form of anaemia [1] .
  • Lead poisoning: A form of MA that is caused when a person is exposed to pollution causing lead poisoning or other situations in which lead affect the count of RBC in the body [7] .
  • Sideroblastic anaemia: It is an inherited condition in which the ability of the bone marrow to manufacture RBC is affected, leading to MA [8] .

Risk Factors Of Microcytic Anaemia

There are several factors that increase the risk of MA. They are as follows:

  • Diet low in iron and folate [1]
  • Menstruation
  • Chronic conditions [6]
  • Pregnancy
  • History of anaemia in the family [9]
  • Age

Complications Of Microcytic Anaemia

If MA is due to simple nutrient deficiencies, it can be cured early but if the condition remains untreated for a long time, it may result in certain complications like

  • Low blood pressure
  • Lungs or other pulmonary problems [10]
  • Shock
  • Heart-related issues

Diagnosis Of Microcytic Anemia

Diagnosis of MA can be carried out by several tests which are as follows:

1. Complete blood count (CBC) test to detect anaemia.

2. Peripheral blood smear test to detect early microcytic changes in RBCs [11] .

3. Blood and stool test to detect the type of MA and its cause.

4. Abdominal ultrasound, upper GI endoscopy and CT scan to rule out abdominal pain caused due to other stomach-related problems.

5. Tests to rule out uterine fibroids in women facing heavy menstruation with pelvic pain.

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Treatment Of Microcytic Anaemia

Treatment of MA is carried out after identifying the type and cause behind it. Most people have mild anaemia, which is completely fine, but if the condition remains for longer, it can damage vital organs.

The basic treatment of MA are as follows:

  • If MA is caused due to lack of iron, a doctor prescribes iron supplements to treat the condition.
  • Antibiotics, if anaemia is caused due to some chronic infection.
  • Certain drugs to increase the count of RBC in the body.
  • The use of hormones if MA is caused due to heavy menstrual bleeding [2] .
  • Surgery if bleeding stomach ulcer is the main cause behind MA.
  • Blood transfusion in a person with severe MA [11] .
  • Chelation, a kind of treatment in which chemicals are used to remove harmful metals from the body.

Prevention Of Microcytic Anaemia

There are several ways by which people can prevent the onset of MA. However, if the condition is inherited, there are no proven ways to prevent it. Other preventive tips of MA are as follows:

  • Eat a balanced diet which includes iron, vitamin C, B12, and folic acid [12] .
  • If your diet is low in iron, go for iron supplements after a consultation from a doctor.
  • Don't give cow's milk to your baby before he/she becomes 1-year-old as it will interfere with their iron absorption capacity later in life.

Food To Avoid Microcytic Anaemia

Iron deficiency is the main of MA in people of all age groups. Here is the list of foods which contains good amount of iron and will help in preventing MA [13] .

  • Egg yolk
  • Beans and lentils
  • Tomatoes and potatoes
  • Raisins
  • Tofu
  • Leafy vegetables
  • Fortified cereals
  • Whole-grain bread
  • Oysters, turkey, and chicken
View Article References
  1. [1] Massey, A. C. (1992). Microcytic anemia. Differential diagnosis and management of iron deficiency anemia. The Medical Clinics of North America, 76(3), 549-566.
  2. [2] Badireddy, M., & Baradhi, K. M. (2018). Chronic Anemia. In StatPearls [Internet]. StatPearls Publishing.
  3. [3] Warner, M., Kamran, M., & Stevens, L. (2018). Anemia, iron deficiency. StatPearls.
  4. [4] Khan, Y., & Tisman, G. (2010). Pica in iron deficiency: a case series. Journal of medical case reports, 4, 86. doi:10.1186/1752-1947-4-86
  5. [5] Needs, T., & Lynch, D. T. (2018). Beta Thalassemia. In StatPearls [Internet]. StatPearls Publishing.
  6. [6] Fitzsimons, E. J., & Brock, J. H. (2001). The anaemia of chronic disease. BMJ (Clinical research ed.), 322(7290), 811–812. doi:10.1136/bmj.322.7290.811
  7. [7] Cohen, A. R., Trotzky, M. S., & Pincus, D. (1981). Reassessment of the microcytic anemia of lead poisoning. Pediatrics, 67(6), 904-906.
  8. [8] Ashorobi, D., & Chhabra, A. (2019). Sideroblastic Anemia. In StatPearls [Internet]. StatPearls Publishing.
  9. [9] lolascon, A., De Falco, L., & Beaumont, C. (2009). Molecular basis of inherited microcytic anemia due to defects in iron acquisition or heme synthesis. Haematologica, 94(3), 395–408. doi:10.3324/haematol.13619
  10. [10] Sarkar, M., Rajta, P. N., & Khatana, J. (2015). Anemia in Chronic obstructive pulmonary disease: Prevalence, pathogenesis, and potential impact. Lung India : official organ of Indian Chest Society, 32(2), 142–151. doi:10.4103/0970-2113.152626
  11. [11] Jimenez, K., Kulnigg-Dabsch, S., & Gasche, C. (2015). Management of Iron Deficiency Anemia. Gastroenterology & hepatology, 11(4), 241–250.
  12. [12] Khan, K. M., & Jialal, I. (2018). Folic Acid (Folate) Deficiency. In StatPearls [Internet]. StatPearls Publishing.
  13. [13] Prentice, A. M., Mendoza, Y. A., Pereira, D., Cerami, C., Wegmuller, R., Constable, A., & Spieldenner, J. (2017). Dietary strategies for improving iron status: balancing safety and efficacy. Nutrition reviews, 75(1), 49–60. doi:10.1093/nutrit/nuw055

Story first published: Sunday, September 15, 2019, 19:00 [IST]
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