Overview of Red Blood Cells
Red blood cells are biconcave/discoid in morphology/shape.
Red blood cells are made up of two major components, the heme and globin.
The heme gives rise to porphyrin and iron
Globin is an amino acid and is reabsorbed after red blood cell breakdown.
Iron part of heme is recycled while the Porphyrin is excreted out as urobilinogen(urine) or stercobilinogen (faeces)
Accumulation of the bilirubin (a product of porphyrin breakdown) is what causes the jaundice you know of (yellowish discoloration of skin, sclera and mucous membranes)
The Iron component of the heme is what the oxygen binds to in haemoglobin (You know red blood cells distribute oxygen throughout the body, I guess.)
If you didn't, now you know 👍
Red blood cells have lifespan of 120days before it is destroyed.
The destruction happens when the red blood cells starts loosing their shape and tends to squeeze as they pass through blood vessels....
On reaching the spleen, the spleen destroys them (into the heme and globin part)
Overview of Anaemia
Anaemia in a layman term is defined as a medical condition where there is reduced red blood cell in the body (for people that knows that there are other types of blood though, hehehe)
There are many loose ends in this definition as it doesn't cover a lot of thing nor tell the full story of what anaemia is exactly.
Scientific Definition Of Anaemia:
Anaemia is a medical condition where there is decrease in red cell count, haemoglobin concentration or packed cell volume below the lower value expected for the individual's age, sex, altitude and state of hydration.
Now understanding anaemia with this definition, you get to see that anaemia is not just the condition with reduced red cell count.
This is because there are people with red cell mass of equal number but because of the age of the persons in question, one may be termed anaemic while the other is not (children has higher red blood cells than the adults),
Same goes to different sex (males generally have higher Haemoglobin count),
The altitude you live (people living at mountains generally tend to have increased red blood cell counts because of reduced oxygen and subsequent erythropoietin synthesis to stimulate the bone marrow cells to produce more), and,
The state of hydration (when dehydrated, the red blood cell count looks increased even though it's same red cell count as they appear clumped together)
There are different types of anaemia but I will be discussing two here (I will try my best not to bore you so try and read through 🙏)
APLASTIC ANAEMIA
This is an anaemic condition caused by the inability of the bone marrow cells to produce enough red blood cells.
Every other factors are okay but the bone marrow isn't equal to the task....
A typical cause of this is chemotherapy.
Chemotherapy is a follow up treatment for cancer patients targeted at reducing the rate of fast dividing cells since cancer cells are one of them too (bear in mind that the bone marrow cells are rapid dividing cells too)
The chemotherapy has no specificity and this makes it attack the bone marrow cells also.
This reduces the bone marrow cells and when "a million cells" is enough to produce the red blood cells that will work for the body is reduced by chemotherapy to "thousand cells",
What do you think will happen?
It's obvious that the red blood cells will also be reduced and this is what we call Aplastic Anaemia.
There are other conditions too and not just chemotherapy.
HEMOLYTIC ANEMIA
Remember the shape of red blood cells?
Don't scroll up ...... Nice you got it😂
Now , what happens here is that the spleen is overworking.....
It destroys red blood cells even before their lifespan of 120days elapse.
The bone marrow keeps on producing adequate red cell counts needed but the spleen keeps destroying them even before they reach the required number of days.
There are many causes of this but basically know that anything that will make the red blood cells to lose their biconcave shape/ discoid shape will automatically lead to Hemolysis and in extension, Hemolytic Anaemia.
Sickling cells, Spherocytosis, Elliptocytosis, Malaria parasites and many other things causes this type.
(Let's talk about Malaria parasites)
When there is high load of P.falciparium (the causative agent of malaria) in the blood (parasitemia), it affects amongst other things the discoid or biconcave shape of the red blood cells and this leads to the destruction of these red blood cells when they reach the spleen thereby causing Hemolysis.
The anti-malarial drugs we take then fights these malarial parasites and defeats them only by clearing the red blood cells they've bounded to which invariably leads to more hemolysis.
This is responsible for the coke coloured urine you see when you're treating malaria.
Let's call it a day😂
I really hope you understood and learnt something new from the post and you can read more here.....
References:
Essential haematology by Hoffbrand
Thanks for reading through 👍