What are the causes of Sickle cell disease

An overview of the causes of anemia

What are the causes of Sickle cell disease

In fact, red blood cells are constantly produced in the body from stem cells in the bone marrow (a spongy tissue found inside some of the bones in the body); This is stimulated by the hormone erythropoietin, which is secreted by the kidneys, and in addition to this hormone, the body needs additional materials to produce healthy red blood cells, including iron, vitamin B12, and folate. Oxygen is transported to different parts of the body, and one red blood cell lives for up to 120 days, after which it breaks down naturally in the body, and it is worth noting that although the body destroys red blood cells after up to 120 days of production, it benefits from the existing iron In the hemoglobin inside the cell, to be used again in the manufacture of new red blood cells.

Accordingly, it can be said that any defect in the production of red blood cells and their life cycle may lead to anemia or anemia. In general, the causes and disorders that lead to anemia can be divided into three main categories; Disorders that cause a deficiency or defect in the process of forming healthy red blood cells, or disorders that increase the rate of red blood cell breakdown or breakdown, or problems that lead to blood loss as a result of bleeding.


Anemia is caused by a disturbance in the production of normal red blood cells

This type of anemia occurs when the body is not able to produce a sufficient number of healthy red blood cells that are able to function efficiently. The health conditions and disorders that cause this type of anemia can be described as follows:

Iron deficiency anemia

Iron deficiency anemia is the most common type of anemia, and it occurs in the event that there is a lack of iron, which is necessary for the formation of the hemoglobin molecule found in red blood cells. Iron through the diet, and the following is a statement of a group of reasons that can lead to this:

  • Eating a diet that is poor in iron and does not provide the body with its need, and examples of iron-rich foods are meat, eggs, and green leafy vegetables.
  • malabsorption of iron from food; As in the case of some diseases and disorders that affect the digestive system and impair its ability to absorb some nutrients, including iron, such as; Celiac disease, which is known among the people as wheat allergy and Crohn's disease, and other causes that can lead to iron malabsorption: Surgical procedures that involve the removal of a large part of the intestine.
  • pregnancy; Without the use of nutritional supplements that contain iron, some pregnant women may develop anemia, as a result of the increased needs of the body and the fetus for iron.
  • chronic and slow bleeding; As in cases of stomach ulcers that are accompanied by bleeding, or infection with some cancers such as colon cancer or uterine cancer, in addition to bleeding that, may occur due to hemorrhoids, or heavy menstrual bleeding.


Vitamin B12 deficiency anemia

Vitamin B12 deficiency anemia occurs when the level of vitamin B12 in the body is lower than normal, and vitamin B12 is one of the vitamins necessary in the formation of red blood cells in the body, and in the event of its deficiency, red blood cells do not mature. This decrease occurs due to several reasons, including the lack of vitamin B12 in the diet, and another related to the presence of some conditions that make the absorption of vitamin B12 difficult, such as some digestive disorders, alcohol consumption, or misuse of nitrous oxide (*), as may occur due to surgery to remove part of the stomach or small intestine, or as a result of taking certain types of medications, in addition to pernicious anemia; It occurs when the body destroys cells responsible for producing intrinsic factor (*), a protein necessary for the absorption of vitamin B12.

Anemia caused by a folic acid deficiency

Folate-deficiency anemia occurs when the level of red blood cells decreases as a result of the body's lack of sufficient amounts of folic acid, a type of vitamin B that is needed to produce red blood cells, and in which the size of red blood cells becomes larger. From the normal range, it should be noted that the deficiency of folic acid in the body may be due to several reasons, including lack of folic acid in the diet, taking some types of medications, prolonged alcohol consumption, or hemolytic anemia; Which will be explained in the article later.


Sickle cell anemia

Sickle Cell Disease, or SCD, is a hereditary red blood cell disorder, in which red blood cells take the shape of a sickle or crescent, a position different from their normal shape, which is supposed to be in the form of a disk, as a result of a change in shape Hemoglobin caused by a genetic defect in the body, which leads to a decrease in the ability of these defective globules to carry oxygen, in addition to an increase in their hardness and an imbalance in their elasticity that allowed them to pass through narrow blood vessels, and therefore may get stuck in the blood vessels during the blood flow, and lead to blockage In whole or in part, causing this feeling of pain due to a lack of oxygen to the cells, and the life rate of red blood cells in sickle cell anemia decreases to range between 10-20 days instead of the normal range (90-120 days), in addition to that the body may fail to compensate A decrease in the number of healthy red blood cells, so their number in the body is insufficient, and thus anemia occurs.


Anemia caused by bone marrow disorders

Bone marrow disorders and problems may lead to anemia, either due to the lack of sufficient numbers of stem cells (*) responsible for the formation of red blood cells, or due to the inefficiency of these cells in developing into normal red blood cells, or because of the growth of cancerous cells in Bone marrow, and it is worth noting that platelets and most types of white blood cells are produced from stem cells in the bone marrow as well, and therefore some types of anemia resulting from bone marrow disorders may lead to low efficiency in the production of white blood cells and platelets in addition to red blood cells, or none at all. Some forms of anemia caused by bone marrow disorders include:

  • Aplastic Anemia: This type of anemia occurs if the stem cells in the bone marrow are damaged and therefore there are not enough stem cells, or they are not present at all, which leads to the insufficient production of red blood cells. Aplastic anemia sometimes leads to aplastic anemia, but it may result from exposure to several factors, such as: undergoing chemotherapy, exposure to radiation, or infection.
  • Myelodysplastic syndrome: Myelodysplastic syndrome, or myelodysplastic syndrome, differs from aplastic anemia in that it is not caused by a deficiency of stem cells; Where a person with the myelodysplastic syndrome usually has a sufficient number of stem cells responsible for the formation of blood cells, but they do not develop and mature normally to form blood cells, resulting in defective and immature blood cells, some of which die in the bone marrow, and others that move to the bone marrow may It does not function normally and does not live long enough, and it is worth noting that a person with the myelodysplastic syndrome may suffer from a decrease in the number of red or white blood cells, or healthy platelets or all of them together.
  • Lead poisoning: Lead is toxic to the bone marrow, and if the body is exposed to lead at high levels, this may lead to a weakness in the production of red blood cells, and thus anemia.

iron anemia

Sideroblastic anemia is a group of blood disorders in which the body cannot properly use iron to manufacture hemoglobin, despite the presence of iron in the body in sufficient quantities. As a result, iron accumulates in red blood cells. The so-called ringed sideroblast appears, which occurs when there is a defect in the ability of the bone marrow to produce normal red blood cells. It should be noted that there are many causes that may lie behind this type of anemia; Which can be idiopathic, genetic, or acquired, such as the use of some types of medications or exposure to some toxic chemicals.

thalassemia

Anemia may occur due to infection with the Mediterranean Basin disease, or as it is called Thalassemia, which is a genetic disorder that may result due to the presence of mutations in the DNA responsible for the manufacture of hemoglobin and red blood cells, which affects the production of enough blood cells Normal red blood cells, and thus the body does not get enough oxygen, and it is worth noting that hemoglobin consists of four protein chains, two alpha chains, and two beta chains, and accordingly thalassemia can be divided into two forms according to the type of chains affected in them; Where the first is known as alpha-thalassemia, and the severity of the disease depends on the number of genetic mutations that have occurred, while the second is called beta-thalassemia, in which the severity of the disease depends on the part of the hemoglobin affected by the mutations.


Chronic disease anemia

Anemia of chronic disease is anemia caused by some chronic diseases, such as cancer, rheumatoid arthritis, Crohn's disease, and many chronic diseases that may affect the production of red blood cells.

Anemia related to kidney disease is also a type of anemia that occurs when the kidneys are unable to perform their functions permanently. Normally, the kidneys secrete the hormone erythropoietin, which stimulates the bone marrow to manufacture red blood cells. If the kidneys lose the ability to function efficiently, anemia may occur that may begin in the early stages of chronic kidney disease, that is when kidney function is normal by 20-50%, and it is indicated that anemia may worsen with the exacerbation and progression of CKD This type of anemia is controlled by the use of synthetic forms of the hormone erythropoietin.

Anemia caused by an increased rate of red blood cell breakdown

Hemolytic anemia occurs if the rate of red blood cell breakdown is greater than the rate of production of new blood cells. Through the spleen and other parts of the body, a process known as hemolysis, but in some cases, the rate of decomposition of these globules may increase and they break down in the body within a shorter period of time, as in the case of autoimmune disorders; Where the body’s immune system mistakenly identifies red blood cells as foreign substances that must be disposed of and attack them, in addition to the presence of some other health conditions and disorders, such as Thalassemia or sickle cell disease, severe high blood pressure, or infection Infection, or bone marrow failure, and others.

Bleeding anemia

Anemia may occur due to exposure to an injury that led to bleeding for a long time, such as surgery, childbirth, an injury that ruptured blood vessels, ulcers in the stomach and small intestine, and benign and malignant tumors in the large intestine, kidneys, and bladder, which leads to a loss of large amounts of blood. From the blood and the red blood cells it carries, and therefore the amount of oxygen transferred to the cells of the body will decrease due to the decrease in the number of red blood cells, and although the bone marrow produces new red blood cells to compensate for the lost quantities, with the continued bleeding, the production may not be sufficient to compensate for the lost, The amount of iron in the body may also be depleted as we mentioned above, and therefore the bone marrow will not be able to compensate for the lost blood, and therefore the cause that led to the bleeding must be treated, and there may be a need for blood transfusions and taking iron supplements if the doctor indicates the necessity of this.

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