However, its causes can be very diverse, meaning that the types of this disease are also numerous. Specifically, this disorder can develop due to the lack of substances necessary for the production of hemoglobin, disruption of the process of formation of red blood cells in the bone marrow, significant or prolonged blood loss, destruction of red blood cells caused by poisons or other adverse factors, hereditary diseases, and the other causes. Therefore, in order for the treatment to be effective, it is imperative to define the type of anemia that is present in the patient.
The 3000 words essay analysis of the information presented in the case, including the chief complaints and the data obtained in the course of diagnostic procedures, makes it possible to identify the disorder in question as microcytic hypochromic anemia that has developed as a result of iron deficiency – a hematologic syndrome characterized by a violation of hemoglobin synthesis due to the lack of necessary microelements, namely iron, in the organism (Rodgers Young, 2013). This diagnosis can be supported by the following facts. First of all, Ms. A’s hemoglobin and hematocrit levels are at 8 g/dl and 38% respectively, which is quite low given the fact that in women, they are expected to be within the range of 12-15.5 /dl and 40% respectively (Rodgers Young, 2013). Moreover, the presence of microcytic and hypochromic cells in the RBC smear demonstrates the reduction in the size of erythrocytes, as well as the decreased concentration of hemoglobin in red blood cells (Rodgers Young, 2013). These symptoms are common for iron deficiency anemia (during which the organism is incapable of producing erythrocytes in the necessary quantities) but are not observed during hemolytic or B12-deficiency anemia. In the first case, red blood cells are being destroyed directly in the bloodstream due to the poisoning or stressful loads, which results in the detection of hemoglobin in the urine, increased levels of bilirubin (a compound that is formed as the result of the breakdown of hemoglobin) in the blood, and, under certain conditions, the change in the form of erythrocytes (Wahed Dasgupta, 2015). In the second case, the deficit of B12 vitamin is accompanied by such symptoms as tingling and numbness in the fingers, a shaky gait, and the enlargement of red blood cells (Wahed Dasgupta, 2015). The signs of hemolytic or B-12 deficit were not observed in Ms. A., which allows excluding the discussed types of anemia when making a diagnosis.
The presented statement is also supported by the fact that the condition of the patient worsens during the menstrual cycle. The latter is associated with the loss of blood as a result of the rejection of the functional layer of the endometrium (the mucous membrane of the uterus) by the organism, which, under the normal conditions, does not have an adverse effect on an individual’s health (Callahan Caughney, 2013). However, it should be noted that Ms. A. also suffers from menorrhagia – an abundant uterine bleeding during menstruation. In women diagnosed with this disorder, periods tend to be prolonged, lasting for seven or more days and resulting in a copious discharge of blood (more than 150 ml) (Smith, 2018). As a result, it is possible to state that Ms. A’s body loses significant amounts of red blood cells on the regular basis and for long periods of time, which leads to an increased consumption of iron by her organism that makes attempts to restore the levels of hemoglobin and hematocrit, thus creating the favorable conditions for the development of anemia. Moreover, it is mentioned in the case that Ms. A. was suffering from menorrhagia for at least 10 years, meaning that chronic blood losses associated with this disease could have resulted in the development of a deficiency of clotting factors (Smith, 2018). In turn, the risks of bleeding and, therefore, the further progression of iron deficiency anemia, are quite considerable for the patient.
The identification of the disorder as microcytic hypochromic iron deficiency anemia that was caused by the regular blood loss makes it possible to recommend a treatment that focuses on addressing the problem of menorrhagia, as well as the replenishment of the reserves of iron in the patient’s organism. It is necessary to point out that for the other types of the disease, namely hemolytic or B12-deficiency one, such measures would have been ineffective, which, once again, signifies the importance of comprehensive diagnostic procedures and a meticulous analysis of the discovered signs and symptoms of the disorder.