Factor XIII Deficiency Clinical Presentation: History, Physical, Causes
6 Types Of Noncancerous Blood Disorders
Noncancerous blood disorders are conditions that affect blood cells, such as red blood cells, white blood cells, and platelets. Blood disorders may cause symptoms and complications, but most are highly treatable.
This article outlines six noncancerous blood disorders and their associated symptoms, treatments, and outlooks. It also offers some general information on how doctors diagnose blood disorders.
Aplastic anemia (AA) is a rare but serious blood condition in which the bone marrow is unable to produce enough new blood cells to support the body's needs.
It occurs because of damage to the stem cells inside the bone marrow. According to the National Health, Lung, and Blood Institute (NHLBI), the most common cause of AA is an autoimmune disease that causes the body to attack its own healthy cells.
Other causes can include:
AA can develop rapidly or slowly and may range from mild to severe.
Symptoms of AA include fatigue, persistent infections, and easy bruising or bleeding
Treatment and outlookTreatments may include the following:
Medical treatments can help manage AA, and blood and bone marrow transplants may even cure the disease for some people.
Without treatment, AA can cause serious complications, such as heartbeat irregularities and heart failure.
Hemolytic anemia (HA) is a condition in which the body destroys red blood cells (RBCs) faster than it can replace them. This results in a low number of RBCs in the blood.
Hemolysis is the medical term for the process that destroys red blood cells. People with conditions that can speed up hemolysis are at increased risk of developing HA. Examples of such conditions include:
The condition can develop rapidly or slowly, and may be mild to severe.
Signs and symptoms of HA may include:
Treatment and outlookPeople with mild, asymptomatic HA may not require treatment. Others may require one or more of the following treatments:
People with severe HA require treatment to help manage the disease and prevent complications.
Sickle cell disease (SCD) is a group of inherited RBC disorders in which RBCs become hard, sticky, and sickle-shaped. This occurs because of an abnormality with the protein "hemoglobin," part of the RBC that carries oxygen.
Sickle cells tend to stick together inside small blood vessels, interrupting blood flow. They also die early, causing a continual shortage of RBCs.
SCD is a genetic condition that is present from birth. It occurs when a person inherits two genes — one gene from each parent — that code for abnormal hemoglobin.
Symptoms of SCD can range from mild to severe and may include the following:
Treatment and outlookThe Food and Drug Administration (FDA) has approved bone marrow transplants or stem cell transplants to treat SCD. However, both procedures are high risk and can cause serious side effects, including death.
In 2023, the FDA approved two gene therapies: Casgevy and Lyfgenia. Gene therapy can modify a person's genes to help treat certain conditions.
Other treatments are available to help manage the disease, alleviate symptoms, and reduce the risk of complications. Some examples include:
According to a 2023 research article, the life expectancy for individuals with SCD is around 20–30 years less than that of individuals who do not have the disease. However, advances in therapy continue to prolong survival rates.
Thalassemia is an inherited blood disorder in which the body cannot make enough hemoglobin. Without sufficient hemoglobin, the RBCs do not function properly and die quickly. This results in fewer healthy RBCs in the blood.
Individuals with moderate to severe thalassemia typically develop symptoms of severe anemia in childhood.
Individuals with relatively mild forms of thalassemia may only find out that they have the condition through blood tests for other health conditions. Less commonly, these individuals may also develop symptoms of anemia.
Some general symptoms of anemia include:
Individuals with thalassemia may develop additional symptoms, such as:
The treatment for thalassemia depends on the severity of the condition. Individuals with anemia may require a blood transfusion to boost RBCs. Those with severe thalassemia may require regular blood transfusions.
People who receive regular blood transfusions may also require chelation therapy to remove excess iron from the blood. In some cases, doctors may also prescribe a folic acid supplement to help boost RBC production.
A 2017 review notes that the outcome for people with thalassemia has improved dramatically over the past 50 years. This is largely due to factors such as an earlier diagnosis and intensified blood transfusion regimens.
Hemophilia is a largely inherited disorder in which the blood does not clot properly, causing an increased risk of bleeding.
Hemophilia involves a mutation in one of the genes that provides instructions for making clotting factor proteins. These proteins allow blood to clot.
Hemophilia can cause the following symptoms:
The life expectancy of those with hemophilia is similar to that of the general population if a person responds well to treatment and does not have other health conditions.
ITP is a blood disorder in which a person has an insufficient number of blood platelets. Platelets are the components of blood that stick together to form a seal over a wound. As such, ITP can cause bleeding issues.
ITP occurs when the immune system mistakenly attacks and destroys the body's platelets or causes the body to make fewer platelets. Researchers do not yet know what causes this to happen, but the following factors may increase the risk:
Some people with ITP may not experience any symptoms, while others will experience symptoms associated with increased bleeding. These may include:
For children with acute ITP, the condition usually goes away on its own within weeks or months and never returns.
The treatment for chronic ITP depends on the person's platelet counts and whether they are experiencing symptoms. Mild cases may require monitoring, while more severe cases may require medical treatment.
Medications are the first-line treatment for children and adults with ITP, and these aim to boost platelet counts. Examples include:
In some cases, doctors may recommend additional treatments, such as platelet transfusions, or surgical removal of the spleen.
The NHLBI explains that ITP is not usually a serious condition, regardless of whether it is acute or chronic.
According to a 2022 research article, most children with acute ITP recover fully within 3–6 months, while around 10–20% go on to develop chronic ITP.
Around 50% of children with chronic ITP experience spontaneous remission of the disease within 5 years of initial diagnosis, with many achieving remission in the first 2 years.
Around 10% of adults with ITP achieve spontaneous remission of the disease within the first 6 months, and around 33–66% of those who do not achieve this will go on to reach a stable platelet count with first-line therapies. Those with remaining ITP will require second-line therapies.
Children and adults rarely die of ITP. When deaths do occur, they are usually the result of excessive bleeding.
When diagnosing blood disorders, doctors will begin by asking about a person's symptoms, medical history, and family history.
A doctor will likely follow up with a blood test called a "complete blood count" (CBC) to assess the following:
Other tests that may help in the diagnosis of noncancerous blood disorders include peripheral blood smear, hemoglobin analysis, genetic testing, and tests of clotting function.
Noncancerous blood disorders may affect red blood cells (RBCs), white blood cells (WBCs), or platelets. Depending on the type, they may cause issues with bleeding or blood clotting, anemia, or increased susceptibility to infection.
Some blood disorders are acute and resolve without treatment, while others may be chronic and require long-term treatment. People with chronic blood disorders may also require treatments to alleviate symptoms of the disease.
Anyone who experiences symptoms of a blood disorder should see a doctor for a diagnosis and appropriate treatment, especially if a blood disorder runs in their family.
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Eating Disorders: Recognizing The Signs And How To Get Help
Many health issues are easy to identify in ourselves and those we care about. That's not always the case when it comes to eating disorders. People who have them may not know it. Or, if they do know, they may be so ashamed that they hide the problem — not only from their family and friends, but also from their doctor.
Dr. Dolores Roman, a 20-year veteran of emergency rooms and a medical director at Independence Blue Cross, has witnessed the impact that eating disorders can have on a person first-hand.
"Too often, there is shame and a stigma associated with having an eating disorder that create barriers to timely care," said Dr. Roman. "Unfortunately, these barriers can result in the disorder going undetected until the condition has progressed to a severe stage. At that point, the individuals suffering have no other choice but to seek emergency care."
Eating disorders are serious mental and physical illnesses that stem from how someone thinks about food, their eating and exercise habits, and their perception of how their body looks. Symptoms commonly appear in adolescence and early adulthood, but eating disorders can affect people of all ages.
"This is not just a youth-specific health concern," said Dr. Roman. "Diagnosis can happen at any time from childhood through advanced adulthood."
CausesGenes play a large role in determining someone's risk for developing an eating disorder, but specific life experiences and events are often triggers, including:
• Abuse during childhood• Bullying• Fat shaming• Having a mental illness• Stress• Dieting• Life transitions such as going through puberty, starting college, getting a new job, and starting or ending a relationship
"Many of the the life experiences and events that trigger eating disorders were particularly exacerbated during the pandemic," Dr. Roman said.
The COVID-19 pandemic was an extremely stressful life experience that changed the ways we lived practically overnight. It disrupted the ways people ate, worked, went to school, and spent time together. During this period, the number of young adults and adolescents seeking treatment for eating disorders increased significantly.
Types of eating disordersThree of the most common eating disorders include binge-eating disorder (BED), bulimia nervosa, and anorexia nervosa.
Binge-eating disorder (BED)People with BED regularly consume large amounts of food in a short time and feel like they can't stop.
Those who have this disorder come in all shapes and sizes. Some are chronic dieters and try to limit how much they eat before and/or after bingeing to "make up" for their behavior.
The biggest health risk from BED is becoming obese, which increases the risk of many other conditions, including Type 2 diabetes and cardiovascular disease.
BulimiaBulimia is when a person has periods of out-of-control eating that are immediately followed by efforts to get rid of the calories consumed by inducing vomiting and/or using diuretics or laxatives. People with bulimia also may over-exercise or fast to avoid gaining weight.
Those who suffer from this eating disorder tend to be overly concerned with their weight and body shape. They can range from mildly underweight to overweight.
Bulimia can cause numerous health problems, many of which result from constantly exposing the throat and mouth to stomach acid due to induced vomiting.
AnorexiaAmong the three most common eating disorders, anorexia is the least prevalent one but the most dangerous. People who have it typically perceive themselves to be overweight, even if they are severely underweight. They are also known to severely restrict their caloric intake and exercise excessively.
Left untreated, anorexia can cause many health problems. They can include things such as thinning of the bones; mild anemia; muscle wasting and weakness; low blood pressure; dizziness or weakness; infertility; heart damage; brain damage; and organ failure. Being anorexic also significantly increases the risk of death by suicide.
Two other less commonly recognized eating disorders are Avoidant Restrictive Food Intake Disorder (ARFID) and pica.
Avoidant Restrictive Food Intake Disorder (ARFID)ARFID is a recently recognized eating disorder. People with it limit the amount (or variety) of foods they eat to the point that it can lead to medical issues, nutritional deficiencies, or psychosocial problems.
People with ARFID often:
• Feel full before eating or have no appetite at all • Only eat foods with certain textures • Fear that eating could cause them to choke or vomit • Become pickier about food until it severely limits what they can eat
PicaThis disorder involves eating things not normally considered to be food, including dirt, clay, crayons, paper, hair, or cigarette butts. People with pica may experience stomach problems, fatigue, and other serious health issues.
Pica is often triggered by nutrient deficiencies that cause cravings for things that are not food. For example, pregnant people and others who have iron-deficiency anemia may crave substances that contain iron. Among children, pica is more frequently seen in those with autism spectrum disorder and those with developmental or intellectual disabilities.
ManagementManagement for eating disorders usually involves a combination of:
• Medical treatment for any physical conditions resulting from the disorder• Monitoring and maintenance of those conditions• Nutritional guidance and education• Cognitive behavioral therapy• Medication, if needed
Depending on the severity of the disorder, a doctor may recommend hospitalization, a residential treatment program, or a day treatment program.
For those who seek help, the odds are in their favor. According to Dr. Roman, "The vast majority of people progress to complete recovery with appropriate care and treatment."
If you are concerned about your own eating behaviors (or those of a loved one), the first step is to talk to your health care provider. They can help you identify a problem, determine the best course of treatment, and prevent the issue from getting worse.
If you are worried that a loved one may be suffering from an eating disorder, it's important to approach them with compassion. Express your concerns with care and empathy. If they're open to talking with you, provide them with a safe place to share their struggles without fear of judgement, and encourage them to seek professional help. Your understanding and support may make all the difference in their journey towards recovery.
ResourcesThere's plenty of resources available for guidance on eating disorders. Organizations that provide educational information and support include:
• National Eating Disorders Association• Eating Disorder Hope• Eating Disorders Coalition• Substance Abuse and Mental Health Services Administration• National Association of Anorexia Nervosa and Associated Disorders (ANAD)
ANAD also operates the National Eating Disorders Helpline, which provides 24/7 support at 1-888-375-7767.
All Independence Blue Cross (IBX) commercial health plans cover nutrition counseling and behavioral health treatment. Members can find eating disorder treatment resources on the organization's Provider Finder and can access Registered Nurse Health Coaches at any time by calling 1-800-ASK-BLUE (1-800-275-2583) (TTY/TDD: 711).
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