MICROCYTIC ANEMIA

Anemia is decreasing of oxygen carrying power each blood volume units because of lower circulating red cell mass which cannot fulfill tissue oxygen demand.1 This condition shown as decreasing of Haemoglobin, hematocrite and packed red cells under normal value. That is cause by acute blood lost or the lower red cell production.
In morphological dan ethiologi, anemia divide as macrocytic normochromic anemia and mikrocytic hipochromic anemia.2 Microcytic means the size under normal. Meanwhile hipochromic means the middle part of red cells seem low reddish at more than 1/3 cell parts. Basically, hipochromic microcytic anemia is part of various anemia within strarting by decreasing of red cells size.
At chronic blood loss, oftenly patients couldnot absorb enough Fe in the intestine to produce red cells faster than blood loss. Which is the red cells produced having small haemoglobins, so that causing microcytic hipochromic anemia.
Here some laboratory criteria:
Mean Corpuscular Volume (MCV) = hematocrite X 10
Red cells mass (juta/mm3)
Normal: 76—96 cμ. MCV ‹ 76 cμ called mikrositic.
Mean Corpuscular Haemoglobin (MCH) = hemoglobin X 10
Red cells mass (juta/mm3)
Normal: 27—32μ μg. Bila MCH ‹ 27μ μg called hipochromic.

Anemia founds in the hole worlds. Despite in the developing countries, it also in the modern countries. This is one of serious public health problems which have higher prevalencies. About 30 % world societies suffer anemia which is the higher prevalencies in the tropic area.3
The ethiology of anemia in modern countries are differ from developing countries. Fe deficiency anemia (include as hipochromic microcytic anemia) is the higher prevalencies in the world. 4 Children and women are the most suffering this. In 1988, Beutler noted that the cause of most anemia in United States were Fe deficiency, Thalassemia, Chronic anemia.5
Microcytic hipochromic anemia


Fe Serum













figure 1. Diagnostic approach of hipochromic microcytic anemia


References

Guyton, Arthur C., M. D. 1986. Buku Ajar Fisiologi Kedokteran. Terjemahan oleh Ken Ariata Tengadi, et. al. 1995. Jakarta: EGC
Saunders, W.B. Company. 1995. Kamus Saku Kedokteran Dorland. Terjemahan oleh Poppy Kumala, dkk. 1998. Jakarta: EGC
Staf Pengajar Ilmu Kesehatan Anak FKUI. 1988. Buku Kuliah 1 Ilmu Kesehatan Anak. Jakarta: Bagian Ilmu Kesehatan Anak FKUI
Staf Pengajar Patologi Klinik FK Unibraw. 1998. Diktat Kuliah Hematopoiesis. Malang.
Staf Pengajar Illmu Penyakit Dalam FK Unibraw. 1998. Catatan kuliah Hematologi. Malang.

Ditulis oleh: Unsiyyatul Usriyyah tahun 2006