4 common symptoms indicating the development of anisocytosis

Anisocytosis is a pathological change in the size of red blood cells and platelets that occurs against the background of various human diseases. Anisocytosis of mixed type is more often diagnosed in medical practice. Blood is the internal medium of the body and performs an important function, providing all organs and systems with oxygen and nutrients. Changes in the shape and size of the cells of this substance often indicate the development of serious diseases, but additional medical research is required to clarify the diagnosis.

Characteristics of anisocytosis, their types

Red blood cells can have different diameters.

A healthy person has red blood cells of all sizes. But a violation of their ratio is a pathology.

The proportion of normocytes should be 70% of the total volume. The volume of microcytes and macrocytes takes up no more than 15% separately.

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Classification of anisocytosis

Erythrocyte anisocytosis is divided into several categories.

Based on the size of the predominant cells, they are distinguished:

1. Macrocytosis – increased number of macrocytes. When red blood cells are too large, there are fewer of them than needed and they carry less hemoglobin. This means that the blood is not sufficiently rich in oxygen. Low blood oxygen saturation causes a variety of symptoms and health problems.
2. Microcytosis – the number of microcytes significantly exceeds the norm. Small red blood cells have a weak ability to carry oxygen, since they have a low concentration of hemoglobin.
3. Mixed variant – increased number of macrocytes and microcytes.

Depending on the severity, the following types of anisocytosis are distinguished:

Reasons for the development of anisocytosis

Etiology of macrocytosis

Vitamin B12 deficiency

Vitamin B12 deficiency is the cause of macrocytosis. A lack of vitamin B12 in the diet is rare and usually occurs only in older people on the “tea-and-toast diet” or in strict vegetarians.

However, deficiency can be caused by the following.

1. Lack of intrinsic factor (an enzyme that ensures the absorption of B12) in patients who have undergone gastrectomy (removal of the stomach) or have pernicious anemia.
2. Vitamin B12 malabsorption resulting from bacterial infection in the small intestine, tapeworm infestation, certain medications, ileal bypass, enteritis, intestinal malabsorption.

Folate deficiency

Folic acid deficiency can also lead to macrocytosis. Its disadvantage arises due to:

• dietary deficiency;
• increased need during pregnancy;
• congenital deficiency;
• malabsorption in the intestine;
• alcoholism.

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Drug-induced macrocytosis

Drug-induced macrocytosis is the most common cause in non-alcoholic patients.

The following categories of drugs are known to cause macrocytosis:

• antagonists (having the opposite effect) of folic acid (Methotrexate);
• purine antagonists (6-Mercaptopurine);
• pyrimidine antagonists (Cytosine arabinoside);
• alkylating agents (Cyclophosphamide);
• inhibitors (inhibiting the action) of tyrosine kinases (Sunitinib and Imatinib);
• Zidovudine;
• Trimethoprim;
• oral contraceptive pills;
• Phenytoin.

The tyrosine kinase inhibitors Sunitinib and Imatinib have been shown to induce macrocytosis in patients with various types of cancer, including renal cell carcinoma (RCC), gastrointestinal tumors, and breast cancer. In patients with RCC, the development of macrocytosis after treatment with Sunitinib may potentially serve as a positive prognostic factor for overall survival.

Persistent anemia of the following types can cause macrocytosis:

• myelodysplastic anemia;
• aplastic anemia;
• acquired sideroblastic anemia.

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Etiology of microcytosis

Microcytosis can occur with several different conditions, ranging from mild problems to more serious ones.

Thalassemia

This is a hereditary blood disorder that parents can pass on to their children due to gene mutations.

With this pathology, the body does not produce enough of a certain protein, usually contained in hemoglobin.

Without it, red blood cell formation does not occur properly.

Chronic conditions

Some chronic diseases can cause microcytosis:

• kidney disease;
• certain types of cancer (Hodgkin's disease, non-Hodgkin's lymphoma, and breast cancer);
• diabetes;
• heart failure;
• Crohn's disease;
• inflammatory bowel diseases;
• rheumatoid arthritis;
• lupus;
• infectious diseases (HIV, AIDS, tuberculosis).

Iron-deficiency anemia

The most common cause of microcytosis is a lack of iron in the blood. Iron deficiency anemia occurs due to:

• insufficient iron intake;
• inability to absorb iron due to certain pathologies (celiac disease or Helicobacter pylori infection);
• chronic blood loss due to frequent or heavy menstrual flow in women or gastrointestinal bleeding;
• pregnancy.

Lead poisoning

Children who are exposed to lead-based paint because they live in an old home or because of toys or other items can suffer lead poisoning.

Polluted water and heavy industrial pollution can also cause lead poisoning, although this is less common.

Sideroblastic anemia

Congenital sideroblastic anemia is an inherited blood disease that affects the ability of the bone marrow to produce red blood cells. It also causes microcytosis, but is less common than other causes.

Symptoms of pathology

Anisocytosis is not an independent disease; the condition is characterized by a disturbance in the composition of the blood under the influence of one or another pathology (for example, anemia, oncology, liver disease). Symptoms of this condition can be very diverse, depending on in which organ the pathological changes occur.

Common signs of anisocytosis include asthenia. The concept implies the development of weakness, fatigue, and irritability in a person. When performing light physical work, the patient notices shortness of breath and loss of strength. Psychological disorders occur. Sleep is often disturbed, mood changes occur, a person becomes aggressive or, conversely, apathy and reluctance to communicate with other people develop.

Many patients are diagnosed with heart rhythm disturbances. As a result, paleness or redness of the skin, dizziness, and flickering of spots before the eyes may occur.

In general, anisocytosis is characterized by signs of heart failure, but when examining the heart, no abnormalities in the functioning of the organ are noted, because the symptoms arise due to a violation of the percentage of blood cells, which can cause difficulties in diagnosis.

Symptoms indicating changes in red blood cells

There are various symptoms of anisocytosis. Some of them are mild, but they can gradually become severe.

A person with anisocytosis often experiences the following symptoms.

1. Rapid breathing. This is a common symptom. Its occurrence is associated with a deficiency of hemoglobin, which leads to insufficient oxygen transport. Thus, patients often feel short of breath after minimal activity.
2. Paleness . Since the necessary oxygen does not reach our skin, nails and eyes as it should, they become paler.
3. Lethargy. With abnormal red blood cell sizes, oxygen distribution is inadequate. Consequently, general fatigue and lethargy are also common symptoms.
4. Tachycardia. Palpitations occur not only after physical activity, but also in normal everyday life. The heart pumps quickly to compensate for the body's need for oxygen, and therefore the number of heartbeats increases.

Some other symptoms may also be present:

• headache;
• low body temperature;
• cold palms and feet;
• dizziness (feeling of falling).

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Analysis on RDW

Blood is examined for anisocytosis during a general analysis. The fence is made from a finger. You need to take it on an empty stomach in the morning. The degree of anisocytosis can be determined manually by laboratory assistants. Today, the RDW index is increasingly calculated using modern hematology analyzers, which provide faster and more accurate results. This parameter is determined automatically using a special formula, taking into account other erythrocyte indices.

The analysis is deciphered by the attending physician, and the values ​​of other indicators are taken into account. Thus, in parallel with the assessment of RDW, the erythrocyte index MCV (average erythrocyte volume) is assessed. This is due to the fact that the anidocytosis index may remain normal, but the presence of micro- and macrocytes is a pathology.

The value of the anisocytosis index is necessary for the doctor to interpret the test result and diagnose anemia, including differential diagnosis. Determining the number of red blood cells in the blood and the level of hemoglobin does not give a complete picture, but only indicates the presence of anemia.

Laboratory diagnostics. Criteria

The main way to diagnose anisocytosis is a blood test.

Red blood cell distribution width (RDW)

This parameter is used to measure the size and volume of red blood cells. RDW increases in accordance with changes in red blood cell size.

The normal RDW parameters are as follows:

If results exceed the normal range, this indicates the presence of anisocytosis.

Doctors often compare the RDW result to the mean cell volume (MCV).

Results may show:

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Color index

Another indicator used in the diagnosis of various types of anisocytosis. They indicate the amount of hemoglobin in a red blood cell.

The normal value is in the range of 0.85 - 1.05.

Hypochromia in a general blood test, when the color index is less than 0.85, may indicate the presence of microcytosis. Hyperchromia (indicator more than 1.0) possibly indicates macrocytosis.

Preventive actions

Anisocytosis is not an independent pathology, but only signals the development of other diseases of the body, so due attention should be paid to the prevention of this condition. To avoid changes in blood composition, you should adhere to the following preventive measures:

• Correctly adjust your diet, saturate your diet with food containing a sufficient amount of iron;
• take blood tests regularly;
• promptly treat infectious diseases;
• to refuse from bad habits;
• pay due attention to sports. Physical activity has a beneficial effect on the body’s metabolic processes, which has a positive effect on blood composition;
• If you notice such signs as weakness, fatigue, apathy, you must inform your doctor about this.

By following a healthy lifestyle, you can prevent serious illnesses. Proper nutrition, hardening and exercise can strengthen the immune system and prevent the development of severe pathologies.

Treatment of anisocytosis

Treatment will depend on the cause of the anisocytosis.

It is important to determine the cause of the problem so that proper treatment can begin.

Anisocytosis is often associated with anemia, and anemia is usually caused by iron or vitamin deficiency.

The usual treatment for iron deficiency is taking iron supplements and changing your diet to increase your iron levels with iron-rich foods.

Iron-rich foods:

• dark green leafy vegetables;
• brown rice;
• beans;
• nuts and seeds;
• meat and fish;
• tofu;
• eggs;
• dried fruits.

Patients can also address vitamin deficiencies by taking supplements and making changes to their diet.

In severe cases of anisocytosis, your doctor may recommend a blood transfusion. This process will replace blood containing abnormal cells with blood containing healthy cells.

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Anisocytosis and poikilocytosis

Anisocytosis and poikilocytosis refer to abnormalities in red blood cells. The key difference between the two is that in anisocytosis the cells are abnormal in size, while in poikilocytosis the red blood cells are abnormally shaped, meaning they do not have the standard biconcave shape.

Types of cell deformation.

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