Anaemia: is it a hidden symptom or a primary disease in modern healthcare?

Anaemia, affecting an estimated 1.6 billion people globally, remains a common diagnosis with complex origins. It manifests in various forms, categorized broadly into microcytic, normocytic, and macrocytic anaemias based on the mean cell volume (MCV). While iron deficiency is the most common cause of anaemia, other causes such as chronic diseases, thalassaemia, and vitamin B12 deficiency play critical roles, complicating diagnosis and management. The challenge for healthcare professionals is to determine whether anaemia is a standalone disease or a symptom of an underlying pathology.

In microcytic anaemia, iron deficiency stands out as the primary cause, especially in women of childbearing age, where blood loss due to menstruation and pregnancy is common. In contrast, normocytic anaemia often reflects systemic disorders like chronic kidney disease or inflammatory diseases. Anaemia of chronic disease (ACD), the second most common type globally, is frequently linked to chronic inflammatory or malignant conditions. Despite the complexity of ACD, effective treatment strategies often include correcting the underlying disorder, though intravenous iron therapy may be considered in specific cases.

Macrocytic anaemia, typically caused by vitamin B12 or folate deficiency, can be more challenging to diagnose due to overlapping symptoms and varying underlying causes, including alcohol use, liver disease, or medications affecting DNA synthesis. Early diagnosis and appropriate treatment, whether through supplementation or addressing primary diseases, are critical to managing anaemia effectively. This article emphasizes the importance of thorough clinical evaluation to distinguish between the multifactorial origins of anaemia and to develop appropriate interventions for affected patients.