Question 1 of 10

    Anemia (Anemic)

    Iron deficiency anemia blood film[1]

    Anemia is defined as a decrease in red blood cell mass. The three main causes include blood loss, increased red blood cell destruction (hemolysis) and decreased production of red blood cells. Iron deficiency is thought to be the most common cause of anaemia globally. Common symptoms are weakness, fatigue, general malaise and dyspnea on exertion. Serious complications of severe anemia arise from tissue hypoxia (shock, hypotension, etc.).

    Presentation

    In the preliminary stages, mild form of anemia has no symptoms. However, when the condition progresses, then the individuals experience the following:

    • Poor concentration
    • Feeling tired more often than usual
    • Occurrence of headaches
    • Chest pain
    • Hands and feet become cold
    • Shortness of breath
    • Irregular or fast heartbeat
    • Dizziness 
    • Development of pale skin

    In more severe cases, individuals would also develop lightheadedness especially when they stand up, development of bluish color in the eyes; nails become brittle and sore tongue [6].

    Entire body system
    Fatigue
    • The condition causes chronic anemia , which can lead to pale skin and fatigue.[merriam-webster.com]
    • In its severe form, it is associated with fatigue, weakness, dizziness and drowsiness.[who.int]
    • It is precisely on a par with anemia , dyspepsia or fatigue, or any other like unhappy fact of personal biography.[thesaurus.com]
    • Along with digestive issues, chronic fatigue, brain fog is often overlooked as a sign of candida and IBD.[draxe.com]
    Pallor
    • Signs and symptoms of anemia may include pallor of the skin and mucous membranes, shortness of breath, palpitations of the heart, soft systolic murmurs, lethargy, and fatigability.[fpnotebook.com]
    • […] aplastic anemia / myelodysplastic syndrome ) Dilutional (rapid IVF infusion) Clinical Features General Anemia Symptoms Most patients begin to be symptomatic at 7gm/dL Weakness , fatigue, lethargy, dyspnea on exertion, palpitations Skin, nail bed, mucosal pallor[wikem.org]
    • The major clinical symptom of anemia and iron deficiency is pallor and its physical symptom is fatigue resulting in reduced capacity to work.[web.worldbank.org]
    • […] or anemiæ ) ( American , uncountable , pathology ) A medical condition in which the capacity of the blood to transport oxygen to the tissues is reduced , either because of too few red blood cells , or because of too little hemoglobin , resulting in pallor[en.wiktionary.org]
    Pediatric Disorder
    Weakness
    • In its severe form, it is associated with fatigue, weakness, dizziness and drowsiness.[who.int]
    • If you have anemia, your body simply doesn’t receive enough oxygen-rich blood, leaving you tired and weak. ( 2 ) Red blood cells contain hemoglobin.[draxe.com]
    • Symptoms and Types Decreased growth rate Anorexia Weakness Lethargy Depression Rapid breathing Increased susceptibility to disease Dark-colored, tarry stools Causes Any form of external blood loss Blood-sucking parasites (e.g., fleas, ticks , hookworms[petmd.com]
    • […] anemia) Impaired production (iron deficiency, folate deficiency , B12 deficiency , aplastic anemia / myelodysplastic syndrome ) Dilutional (rapid IVF infusion) Clinical Features General Anemia Symptoms Most patients begin to be symptomatic at 7gm/dL Weakness[wikem.org]
    • […] from Greek anaimia bloodlessness, from a- -aimia -emia ANEMIA Defined for English Language Learners noun Definition of anemia for English Language Learners medical : a condition in which a person has fewer red blood cells than normal and feels very weak[merriam-webster.com]
    Weight Loss
    • People who have had gastric bypass surgery for weight loss or other reasons may also be iron deficient due to poor absorption.[hematology.org]
    • Certain health conditions, such as Crohn's disease or celiac disease, or gastric bypass surgery for weight loss can make it harder for your body to absorb iron from food.[womenshealth.gov]
    • Note any neurologic/behavioral changes which would force emergent consideration of thrombotic thrombocytopenic purpura (TTP) and systemic symptoms (e.g. weight loss or edema, B symptoms) suggesting underlying malignancy/renal failure, etc.[clinicaladvisor.com]
  • more...
  • neurologic
    Dizziness
    • In its severe form, it is associated with fatigue, weakness, dizziness and drowsiness.[who.int]
    • […] enough iron, folic acid or vitamin B12 Blood disorders such as sickle cell anemia and thalassemia , or cancer Aplastic anemia , a condition that can be inherited or acquired G6PD deficiency , a metabolic disorder Anemia can make you feel tired, cold, dizzy[medlineplus.gov]
    • Symptoms may include: Abnormal paleness or lack of color of the skin Increased heart rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo especially when standing[chop.edu]
    • The symptoms may include, but are not limited to: Abnormal paleness or lack of color of the skin Increased heart rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo[stanfordchildrens.org]
    • But as it gets worse, you may have these signs and symptoms: Fatigue (very common) Dizziness Headache Cold hands and feet Pale skin Irregular heartbeat Chest pain Because your heart has to work harder to pump more oxygen-rich blood through the body, all[marchofdimes.org]
    Headache
    • You may be short of breath or have a headache.[medlineplus.gov]
    • Symptoms may include: Abnormal paleness or lack of color of the skin Increased heart rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo especially when standing Headache[chop.edu]
    • […] are not limited to: Abnormal paleness or lack of color of the skin Increased heart rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo, especially when standing Headache[stanfordchildrens.org]
    • Symptoms can include headaches, chest pains, and a paleness of skin.[medicalnewstoday.com]
    • Symptoms that may occur first include: Feeling weak or tired more often than usual, or with exercise Headaches Problems concentrating or thinking If the anemia gets worse, symptoms may include: Blue color to the whites of the eyes Brittle nails Desire[uihc.org]
    Vertigo
    • Symptoms may include: Abnormal paleness or lack of color of the skin Increased heart rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo especially when standing[chop.edu]
    • The symptoms may include, but are not limited to: Abnormal paleness or lack of color of the skin Increased heart rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo[stanfordchildrens.org]
  • more...
  • Skin
  • more...
  • respiratoric
    Dyspnea
    • […] iron deficiency, folate deficiency , B12 deficiency , aplastic anemia / myelodysplastic syndrome ) Dilutional (rapid IVF infusion) Clinical Features General Anemia Symptoms Most patients begin to be symptomatic at 7gm/dL Weakness , fatigue, lethargy, dyspnea[wikem.org]
    • Symptoms may include: Abnormal paleness or lack of color of the skin Increased heart rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo especially when standing[chop.edu]
    • The symptoms may include, but are not limited to: Abnormal paleness or lack of color of the skin Increased heart rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo[stanfordchildrens.org]
  • more...
  • gastrointestinal
    Abdominal Pain
    • […] anemia can have specific symptoms unique to their type: Aplastic anemia - fever, frequent infections, and skin rashes Folic acid deficiency anemia - irritability, diarrhea, and a smooth tongue Hemolytic anemia - jaundice, dark colored urine, fever , and abdominal[medicalnewstoday.com]
  • more...
  • cardiovascular
    Heart Murmur
    • murmur Low blood pressure, especially when you stand up Pale skin Rapid heart rate Some types of anemia may cause other findings on a physical exam.[uihc.org]
    Palpitations
    • Signs and symptoms of anemia may include pallor of the skin and mucous membranes, shortness of breath, palpitations of the heart, soft systolic murmurs, lethargy, and fatigability.[fpnotebook.com]
    • […] folate deficiency , B12 deficiency , aplastic anemia / myelodysplastic syndrome ) Dilutional (rapid IVF infusion) Clinical Features General Anemia Symptoms Most patients begin to be symptomatic at 7gm/dL Weakness , fatigue, lethargy, dyspnea on exertion, palpitations[wikem.org]
    • The signs of anemia are paleness, tiredness, headache, shortness of breath, dizziness, or heart palpitations.[ihtc.org]
    • This form of " dilutional anemia " is common, and the increased blood volume can cause heart palpitations (that feeling of your heart skipping a beat).[khanacademy.org]
    Systolic Murmur
    • Signs and symptoms of anemia may include pallor of the skin and mucous membranes, shortness of breath, palpitations of the heart, soft systolic murmurs, lethargy, and fatigability.[fpnotebook.com]
    Tachycardia
    • Anemia may be suspected on a complete medical history and physical examination of your child, such as complaints of tiring easily, pale skin and lips, shortness of breath, or a fast heartbeat (tachycardia).[stanfordchildrens.org]
    • Symptoms may include: Abnormal paleness or lack of color of the skin Increased heart rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo especially when standing[chop.edu]
    • Cardiac exam for tachycardia (acute blood loss or sepsis), murmurs (hemolysis due to endocarditis or a mechanical valve), or signs of volume overload.[clinicaladvisor.com]
    • In severe anemia, there may be signs of a hyperdynamic circulation: tachycardia (a fast heart rate), bounding pulse, flow murmurs, and cardiac ventricular hypertrophy (enlargement).[en.wikipedia.org]
  • more...
  • urogenital
    Amenorrhea
    • […] rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo especially when standing Headache Irritability Irregular menstruation cycles Absent or delayed menstruation (amenorrhea[chop.edu]
    • […] rate (tachycardia) Breathlessness, or difficulty catching a breath (dyspnea) Lack of energy, or tiring easily (fatigue) Dizziness, or vertigo, especially when standing Headache Irritability Irregular menstruation cycles Absent or delayed menstruation (amenorrhea[stanfordchildrens.org]
    • Children 0-5 years and women % children % children % children % people following BCC messages to prevent and treat infectious diseases Family Planning Promote breastfeeding for lactatioinal amenorrhea method (LAM) and modern methods of contraceptives[web.worldbank.org]
  • more...
  • Eyes
  • more...
  • Ears
  • more...
  • Workup

    The following methods are employed to diagnose anemia:

    • Physical examination is done to carefully evaluate the signs and symptoms of anemia. In this, the heartbeat is studied along with other physical parameters such as size of the liver and spleen [7].
    • Blood tests to obtain a complete blood count would be made. The levels of hemoglobin are of primary interest. According to the values provided by WHO, males with hemoglobin values lower than 13.5g/dL and women with less than 12.5g/dL are considered to anemic. Blood tests in most cases also help identify the presence of underlying disease condition if any.
    • Other tests would be carried out to establish the size and shape of the red blood cells. This is necessary because the size and shape of the cells changes with the type of anemia present. Individuals with iron deficiency anemia have smaller sized red blood cells; whereas those with vitamin deficiency anemia have enlarged RBCs [8].

    Test Results

    Other Test Results
  • more...
  • Laboratory

    Serum
  • more...
  • ECG

    Rhythm
  • more...
  • Treatment

    Treatment of anemia depends on its type. The following methods are employed to treat different types of anemia:

    • Iron deficiency anemia is treated with iron supplements and changes in dietary pattern [9].
    • B12 deficiency anemia can be treated with providing supplements of folate and vitamin B12. These nutrients are also provided through diet. In case, the body is unable to absorb these through diet then vitamin B12 injections are given.
    • Anemia due to chronic disease condition has no specific treatment regime. In this, modes are employed for treating the underlying disease condition. When symptoms turn severe then, blood transfusion may be necessary.
    • Aplastic anemia is treated through blood transfusions and bone marrow transplantation.
    • Sickle cell anemia may require blood transfusions, antibiotics and supplements of folic acid. In certain cases, bone marrow transplant may be indicated.
    • Thalassemia is primarily treated through blood transfusions. In many instances, splenectomy and bone marrow transplant would be required [10].

    Prognosis

    The prognosis depends on the type of anemia and the causative factors. Mild forms can be successfully treated with supplements and intake of iron rich diet. However, certain forms can be severe and require a more rigorous treatment regime. Such types include sickle cell anemia, thalassemia and aplastic anemia. Anemia that results from aortic rupture has a very poor prognosis with about 80% mortality rate [5].

    Complications

    Edema
    • Note any neurologic/behavioral changes which would force emergent consideration of thrombotic thrombocytopenic purpura (TTP) and systemic symptoms (e.g. weight loss or edema, B symptoms) suggesting underlying malignancy/renal failure, etc.[clinicaladvisor.com]
    High Output Heart Failure
    • Severely anemic patients can develop high output heart failure, so careful monitoring is required.[clinicaladvisor.com]
    Hypervolemia
    • Fluid overload (hypervolemia) causes decreased hemoglobin concentration and apparent anemia: General causes of hypervolemia include excessive sodium or fluid intake, sodium or water retention and fluid shift into the intravascular space.[en.wikipedia.org]
    Hypotension
    • In the euvolemic patient, hypotension may be a late, pre-terminal event and tachycardia, anxiety, and tachypnea may be important signs of instability.[clinicaladvisor.com]
    Leukopenia
    • Often accompanied by thrombocytopenia, or leukopenia, and diagnosed by a bone marrow biopsy.[clinicaladvisor.com]
    Restless Legs Syndrome
    • Ascertainment of iron deficiency and depletion in blood donors through screening questions for pica and restless legs syndrome .[womenshealth.gov]
    • Restless legs syndrome is more common in those with iron-deficiency anemia.[en.wikipedia.org]
  • more...
  • Etiology

    Anemia occurs due to any of the 3 causes which include; loss of blood, decreased production of red blood cells and hemolysis characterized by increased destruction of red blood cells. There are several causative factors such as genetic, nutritional, physical and underlying disease conditions that can give rise to anemia.

    • Genetic factors such as development of thalassemia, heredity xerocytosis, Fanconi anemia, Rh null disease and defects in RBC cytoskeleton can lead to anemia.
    • Nutritional deficiencies including deficiency of iron, folate and vitamin B12 can cause anemia to set in.
    • Physical factors that can cause blood loss include burns, trauma, prosthetic valves and frostbite can lead to development of anemia.
    • Underlying disease conditions such as neoplasia, renal disease, liver disease and collagen vascular disease can predispose an individual to develop anemia [2].

    Epidemiology

    It has been estimated that, about 1 billion individuals across the globe suffer from iron deficiency anemia. Women and children are more affected than men. According to WHO, men and women having hemoglobin levels below 12.5g/dL are considered to be suffering from anemia. For the US population, levels of 12.5g/dL for women and 13.5g/dL for men are considered to be cut off values. Based on these values, 4% men and 8% women are known to have lower than normal hemoglobin levels in the US [3].

    Sex distribution
    Age distribution

    Pathophysiology

    Under normal physiologic conditions, the red blood cells (RBCs) of the body contain hemoglobin. The RBCs with the help of hemoglobin are responsible for carrying oxygen to the lungs and various other parts of the body. They also carry carbon dioxide from parts of the body to the lungs for it to be exhaled. Red blood cells are made regularly in the bone marrow. For the bone marrow to produce RBCs and hemoglobin, it needs adequate amounts of iron, vitamin B12, folate and other essential nutrients. Deficiency in any of these nutrients means inadequate amounts of hemoglobin is being produced, leading to anemia [4].

    Prevention

    Some forms of anemia can be prevented. Those that occur due to iron and vitamin deficiency can easily be prevented by choosing a diet rich in these nutrients. Those who are vulnerable towards anemia, for eg; children and pregnant women should consider taking supplements. There are other forms of anemia which cannot be prevented. However, treatment should be initiated right when preliminary signs develop to prevent complications from setting in.

    Summary

    Anemia is characterized by decrease in the number of red blood cells or hemoglobin in the blood. In other words, when the blood loses its capacity to carry oxygen, the individual is known to have developed anemia. Individuals with anemia often complain of tiredness and weakness. Anemia is of several types, and all have different causative factors. It is a common occurrence and can affect individuals of any age group. If the condition is not treated on time, it can lead to serious and long term debilitating complications [1]. 

    Patient Information

    Definition

    Anemia is a condition defined by significant reduction in hemoglobin levels, like below 12.5g/dL. In this condition, the body does not produce adequate red blood cells. Anemia is more prevalent in women and children. It has been estimated that about 1.5 billion individuals across the globe suffer from anemia.

    Cause

    Causes of anemia include blood loss due to trauma or other disease conditions and inadequate production or early destruction of red blood cells.

    Symptoms

    Individuals with anemia suffer from fatigue, weakness, headache, and lightheadedness, pale color of the skin, brittle nails and concentration problems.

    Diagnosis

    Diagnosis of anemia includes physical examination followed by blood tests to determine complete blood count. In addition, specialized tests to determine the size and shape of red blood cells would also be required.

    Treatment

    Anemia is treated through supplements and modification in diet. Many forms of anemia may require blood transfusions and bone marrow transplants.

    Self-assessment

    Ask Question


    5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.

    References

    1. Beutler E, Waalen J. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood 2006; 107:1747.
    2. Young NS, Scheinberg P, Calado RT. Aplastic anemia. CurrOpinHematol. May 2008;15(3):162-8.
    3. Patel KV. Epidemiology of anemia in older adults.SeminHematol 2008; 45:210.
    4. Nutritional anaemias.Report of a WHO scientific group. World Health Organ Tech Rep Ser 1968; 405:5
    5. DeLoughery TG. Microcytic anemia. N Engl J Med. Oct 2 2014;371(14):1324-31.
    6. Means RT, Glader B. Anemia: General Considerations. In: Wintrobe's Clinical Hematology, 12 Ed, Greer JP, Foerster J, Rodgers GM, et al. (Eds), Lippincott Williams and Wilkins, Philadelphia 2009. Vol 1, p.784.
    7. Rapaport SI. Diagnosis of anemia. In: Introduction to hematology, JB Lippincott, Philadelphia 1987. p.15
    8. Kuku I, Kaya E, Yologlu S, Gokdeniz R, Baydin A. Platelet counts in adults with iron deficiency anemia.Platelets. Aug 3 2009;1-5.
    9. Mozaffari-Khosravi H, Noori-Shadkam M, Fatehi F, Naghiaee Y. Once weekly low-dose iron supplementation effectively improved iron status in adolescent girls. Biol Trace Elem Res. Aug 4 2009;epub ahead of print.
    10. Borgna-Pignatti C, Rugolotto S, De Stefano P, et al. Survival and complications in patients with thalassemia major treated with transfusion and deferoxamine. Haematologica. Oct 2004;89(10):1187-93.

    • Anemia and red cell distribution width at the 12-month well-baby examination - YS Choi, T Reid - SOUTHERN MEDICAL JOURNAL-BIRMINGHAM , 1998 - idpas.org
    • Anemia and infant behavior. - DL Johnson, RJ McGowan - Nutrition & Behavior, 1983 - psycnet.apa.org
    • A Case of Lead Poisoning After Ingestion of Herb Pills - SW Oh, HJ Lee, HJ Chae, SK Lee, JD Moon - Korean Journal of , 2007 - KoreaMed
    • Clinical pallor is useful to detect severe anemia in populations where anemia is prevalent and severe - RJ Stoltzfus, A Edward-Raj, ML Dreyfuss - The Journal of , 1999 - Am Soc Nutrition
    • Aortic insufficiency in five patients with Reiter's syndrome: a detailed clinical and pathologic study - HE Paulus, CM Pearson, W Pitts - The American journal of medicine, 1972 - Elsevier
    • Anemia and papilledema - V Biousse, JC Rucker, C Vignal, I Crassard - American journal of , 2003 - Elsevier
    • Effect of acute anemia on the healing of intestinal anastomoses in the rabbit - TL Buchmiller-Crair, CS Kim, NH Won - The Journal of , 2001 - journals.lww.com
    • Acquired trichomegaly of the eyelashes: a cutaneous marker of acquired immunodeficiency syndrome - MH Kaplan, NS Sadick, M Talmor - Journal of the American Academy of , 1991 - Elsevier
    • 11.4 Dizziness - I Nazareth - Oxford Textbook of Primary Medical Care: Clinical , 2004 - books.google.com
    • Adverse reactions to quinidine in hospitalized patients: findings based on data from the Boston Collaborative Drug Surveillance Program - IS Cohen, H Jick, SI Cohen - Progress in cardiovascular diseases, 1977 - Elsevier
    • Acute myocardial infarction in sickle cell anemia - CR Martin, C Cobb, D Tatter, C Johnson - Archives of Internal , 1983 - Am Med Assoc
    • Cardiovascular effects of anemia - MA Varat, RJ Adolph, NO Fowler - American heart journal, 1972 - anesthesiaweb.org
    • Anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue - D Cella, DT Eton, JS Lai, AH Peterman - Journal of pain and , 2002 - Elsevier
    • A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure - MW Rich, V Beckham, C Wittenberg - England Journal of , 1995 - Mass Medical Soc
    • Anemia and hypotension as contributors to perioperative loss of vision - RH Brown, JF Schauble, NR Miller - Anesthesiology, 1994 - journals.lww.com
    • A phase I/II trial of the oral mTOR-inhibitor Everolimus (E) and Imatinib Mesylate (IM) in patients (pts) with gastrointestinal stromal tumor (GIST) refractory to IM: Study - A Van Oosterom, P Reichardt, JY Blay - ASCO meeting , 2005 - meeting.ascopubs.org
    • 2002 E. Mead Johnson Award for research in pediatrics lecture: the molecular biology of the anemia of chronic disease: a hypothesis - CN Roy, DA Weinstein, NC Andrews - Pediatric research, 2003 - nature.com
    • A prognostic score for advanced Hodgkin's disease - D Hasenclever, V Diehl, JO Armitage - England Journal of , 1998 - Mass Medical Soc
    • Exercise as disease detector - ER Eichner, WA Scott - Physician and sportsmedicine, 1998 - physsportsmed.org
    • Cardiac involvement in Cooley's anemia - MA Engle - Annals of the New York Academy of Sciences, 2006 - Wiley Online Library
    • A new variant of hereditary hemolytic anemia with stomatocytosis and erythrocyte cation abnormality - DR MILLER, FR RICKLES - , 1971 - bloodjournal.hematologylibrary.org
    • A reduced-fat diet and aerobic exercise in Japanese Americans with impaired glucose tolerance decreases intra-abdominal fat and improves insulin sensitivity but not - DB Carr, KM Utzschneider, EJ Boyko, PJ Asberry - Diabetes, 2005 - Am Diabetes Assoc
    • Content of Riboflavin and Riboflavin‐containing Co‐enzymes in the Blood in Health and in Various Diseases, in Particular Schizophrenia, Neurocirculatory Asthenia - W KERPPOLA - Acta Medica Scandinavica, 1955 - Wiley Online Library
    • Clinicopathological Conference: Syncope and Pulmonary Hypertension in a 38-Vear-Oid Man - GM Bhatt, SL Kamholz, JKH Li - The Einstein Quarterly , 1985 - ojs.library.einstein.yu.edu
    • A neurological syndrome associated with orthostatic hypotension: a clinical-pathologic study - GM SHY, GA DRAGER - Archives of neurology, 1960 - Am Med Assoc
    • Anemia and change in hemoglobin over time related to mortality and morbidity in patients with chronic heart failure results from Val-Heft - IS Anand, MA Kuskowski, TS Rector, VG Florea - Circulation, 2005 - Am Heart Assoc
    • AIDS with Mycobacterium avium-intracellulare lesions resembling those of Whipple's disease - RL Strom, RP Gruninger, RI Roth - New England Journal , 1983 - Mass Medical Soc
    • Analysis of 40 sporadic or familial neonatal and pediatric cases with severe unexplained respiratory distress: relationship to SFTPB - M Tredano, M Griese, J de Blic, T Lorant - American Journal of , 2003 - Wiley Online Library
    • 2 Gaucher Disease - E Beutler - Advances in genetics, 1995 - Elsevier
    • Endoscopic biopsy is diagnostic in gastric antral vascular ectasia - JH Gilliam, KR Geisinger, WC Wu, N Weidner - Digestive diseases and , 1989 - Springer
    • A case of myxedema with macrocytic anemia successfully treated with thyroid and testosterone - SJ Glass - The Journal of Clinical Endocrinology, 1943 - Endocrine Soc
    • Chronic fatigue syndrome: an update - AL Komaroff, MD - Annual review of medicine, 1998 - annualreviews.org
    • Anemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with advanced heart - TB Horwich, GC Fonarow - Journal of the , 2002 - Am Coll Cardio Found
    • A Clinical Study of the Brachial Arterial Pulse Form: With Special Reference to the Diagnosis of Aortic Valvular Disease - EW HANCOCK, WH ABELMANN - Circulation, 1957 - Am Heart Assoc
    • Anemia of prematurity. Current concepts in the issue of when to transfuse. - JA Stockman 3rd - Pediatric Clinics of North America, 1986 - ukpmc.ac.uk
    • Angina pectoris among 10,000 men: II. Psychosocial and other risk factors as evidenced by a multivariate analysis of a five year incidence study - JH Medalie, U Goldbourt - The American journal of medicine, 1976 - Elsevier
    • Anemia, chronic renal disease and congestive heart failure—the cardio renal anemia syndrome: the need for cooperation between cardiologists and nephrologists - DS Silverberg, D Wexler, A Iaina, S Steinbruch - urology and nephrology, 2006 - Springer

    Media References

    1. Iron deficiency anemia blood film, CC BY-SA 3.0

    Languages

    Self-assessment