Blood disorders affect 3 major components of a patient’s blood:
- Red blood cells: carry oxygen to various parts of body tissues;
- White blood cells: fight infection;
- Platelets: help blood clot in wounds.
Blood disorders may also affect the fluid part of the blood, such as plasma.
The treatment and prognosis for blood disorders varies, depending on the component of the blood affected and the severity of the patient’s condition.
The main red blood cell-related blood disorder is anemia, in which patients with anemia have reduced red blood cell counts and hemoglobin levels. Mild anemia is usually asymptomatic. More severe anemia can lead to fatigue, pale skin, shortness of breath, and even anemic heart and brain lesions.
Iron deficiency anemia
Iron is an essential element for the body to produce red blood cells. The most common causes of iron deficiency anemia are inadequate iron intake and heavy menstrual blood loss; bleeding from gastrointestinal ulcers or cancer can also trigger iron deficiency anemia. Treatment options include treatment of the primary cause and supplemental iron intake, with severe cases requiring blood transfusion therapy.
Anemia due to chronic disease
Patients with chronic kidney disease or other chronic conditions are more likely to develop anemia. Anemia due to chronic disease usually requires treatment of the primary disease, but in some patients with chronic disease with anemia, erythropoietin injections to stimulate blood cell production or transfusion therapy may be necessary.
Pernicious anemia (vitamin B12 deficiency)
Patients with this disease are unable to absorb enough vitamin B12 from food. The cause may be low absorption in the gastric mucosa or due to an autoimmune disease. In addition to anemia, patients may eventually develop nerve damage (neuropathy). Giving patients high doses of vitamin B12 on a daily basis can help prevent long-term health problems.
Aplastic anemia
In patients with aplastic anemia, the bone marrow is unable to produce enough blood cells, including red blood cells, white blood cells, and platelets. Aplastic anemia or dysplasia can be triggered by a variety of clinical causes, including:
- Hepatitis virus, EBV or HIV infection;
- Drug side effects;
- Treatment with chemotherapy regimens;
- Pregnancy.
Aplastic anemia requires medication, blood transfusions, and even bone marrow transplant treatment.
Autoimmune hemolytic anemia
Patients with this disease have an overactive immune system, which destroys their own red blood cells and leads to anemia. Patients need to use drugs that suppress the body’s immune function, such as prednisone, to stop the abnormal destruction of red blood cells.
Thalassemia
This is an inherited form of anemia that primarily affects people of Mediterranean ethnicity. Most mild cases have no obvious symptoms and do not require treatment. Some patients may need regular blood transfusions to relieve the symptoms of anemia, especially in children.
Sickle cell anemia
A genetic anemia that affects populations mainly in Africa, South or Central America, Caribbean islands, India, Saudi Arabia, and Mediterranean countries, including Turkey, Greece, and Italy. In patients with sickle cell anemia, diseased red blood cells become stiff and illiquid, which accelerates destruction. They also undergo severe pain and organ damage.
True erythrocytosis
The patient’s body produces too many blood cells for unknown reasons. The excess red blood cells usually cause a slowing of blood flow, which in severe cases may lead to blood clots in some patients.
Malaria
Mosquito bites spread the malaria parasite into the body’s bloodstream and infect red blood cells. The red blood cells rupture periodically, causing fever, chills, and organ damage in patients. This blood infection is most common in parts of Africa, but can occur in other tropical and subtropical regions around the world; travelers to areas at high risk for disease prevalence should take precautions beforehand.
The following are leukocyte-associated blood disorders:
Lymphoma
A blood tumor formed by malignant proliferation of lymphocytes in the lymphatic system or abnormal proliferation of lymphoid organs. In patients with lymphoma, lymphocytes can transform into malignant tumor cells that appear to proliferate and spread abnormally. The two main types of lymphoma include Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Chemotherapy or radiation therapy is often effective in prolonging the survival of patients with lymphoma, and sometimes even curing it.
Leukemia
This is a tumor arising from an abnormal proliferation of white blood cells in the blood system, in which the patient’s white blood cells become malignant and proliferate abnormally in the bone marrow. Leukemia can be acute (severe and rapidly progressive) or chronic (slow progression). Chemotherapy or stem cell transplantation (bone marrow transplantation) can be used to treat patients with leukemia and may even lead to a cure.
Multiple myeloma
This is a tumor of the blood that results from the abnormal proliferation of cells called “plasma cells. Plasma cells can proliferate and release harmful substances that eventually cause damage to organs and bones. There is no cure for multiple myeloma, but stem cell transplantation or chemotherapy can keep most patients alive longer.
Myelodysplastic syndrome
A blood tumor that originates in the bone marrow. Myelodysplastic syndrome usually progresses very slowly, but can suddenly turn into a severe form of leukemia. Treatment options include blood transfusions, chemotherapy, and stem cell transplantation.
What are the platelet-related blood disorders?
Thrombocytopenia
Decreased number of platelets in the blood; many diseases can cause thrombocytopenia, but most conditions do not cause abnormal bleeding in patients.
Idiopathic thrombocytopenic purpura
A condition in which the number of platelets in the blood decreases continuously due to abnormal immune function; it usually has no serious symptoms but causes abnormal bruising or erythema of the skin and, in severe cases, abnormal or severe bleeding.
Heparin-induced thrombocytopenia
Decreased platelet count due to the patient’s response to heparin. Heparin is an anticoagulant that is used to prevent the formation of blood clots in many hospitalized patients.
Thrombotic thrombocytopenic purpura
This is a rare blood disorder that causes microscopic clots to form in blood vessels throughout the patient’s body for a variety of reasons; platelets are depleted in the process, causing their levels to decrease significantly.
Primary thrombocythemia
For unknown reasons, the body produces too many platelets; the excess platelets can eventually cause bone marrow fibrosis, extramedullary hematopoiesis, splenomegaly, and allogeneic hematopenia. Patients may present with excessive clotting in the early stages and bleeding in the later stages.
Blood disorders associated with abnormal plasma composition: hemophilia, genetic defects in certain proteins that assist in blood clotting; there are several types of hemophilia, varying in severity from mild symptoms to life-threatening.
Vascular hemophilia
Vascular hemophilia factor is a protein in the blood that helps blood to clot. People with vascular hemophilia have low or malfunctioning levels of this protein in their bodies. The disease is a genetic disorder, but most patients with vascular hemophilia have bleeding symptoms such as epistaxis as young children, which lessen as they get older. In some patients, heavy bleeding may occur after injury or surgery.
Hypercoagulable state
The blood has a tendency to clot; most patients have only a mild tendency to overcoagulate and may not seek medical confirmation for this. However, some patients have recurrent clotting that can severely affect vital organs, and these patients require daily anticoagulants.
Deep vein thrombosis
Blood clots form in the body’s deep veins, usually in the legs; deep vein clots can dislodge and travel through the heart to the lungs, causing a pulmonary embolism.
Diffuse intravascular coagulation (DIC)
This is a serious condition in which various diseases cause microscopic blood clots in blood vessels throughout the body, leading to a significant increase in the risk of bleeding due to decreased platelet and clotting factor depletion; severe infections, major surgery, or pregnancy complications can trigger disseminated intravascular coagulation.