What diseases cause the three major causes of anemia

Many people do not pay much attention to anemia, and those suffering from anemia rarely consider the real cause of the disease. In fact, the cause of anemia is very important. Anemia is not only caused by lack of blood, but may also be caused by certain diseases in the body. Therefore, if you suffer from anemia, you must first find out the cause of the disease.

(1) Anemia caused by abnormal hematopoietic stem cell

AA is a bone marrow hematopoietic failure disease associated with primary and secondary hematopoietic stem and progenitor cell damage. The pathogenesis of partial pancytopenia is related to the production of anti-bone marrow cell autoantibodies by B cells, which in turn destroy or inhibit bone marrow hematopoietic cells.

PRCA refers to damage to erythroid hematopoietic stem cells in the bone marrow, which in turn causes anemia. Depending on the cause, the disease can be divided into two categories: congenital and acquired. Congenital PRCA is Diamond-Blackfan syndrome, which is caused by inheritance; acquired PRCA includes primary and secondary types. Some scholars have found that some primary PRCA patients have autologous EPO or immature erythrocyte antibodies in their serum. Secondary PRCA mainly includes drug-related type, infection-related type (bacteria and viruses, such as parvovirus B19, hepatitis virus, etc.), autoimmune disease-related type, lymphoproliferative disease-related type (such as thymoma, lymphoma, plasma cell disease and lymphocytic leukemia, etc.) and acute aplastic crisis.

CDA is a type of refractory anemia caused by a hereditary benign clonal abnormality of erythroid stem and progenitor cells, characterized by ineffective erythroid hematopoiesis and morphological abnormalities. According to the inheritance mode, the disease can be divided into autosomal recessive inheritance type and dominant inheritance type.

These diseases involve qualitative abnormalities in hematopoietic stem and progenitor cells, including myelodysplastic syndrome and various hematopoietic tumor diseases such as leukemia. The former is caused by pathological hematopoiesis, high proliferation, high apoptosis, and in situ hemolysis; the latter is caused by neoplastic proliferation, low apoptosis and low differentiation, which also affects hematopoietic regulation, resulting in a decrease in normal mature red blood cells and anemia.

(2) Anemia caused by abnormal hematopoietic microenvironment

The hematopoietic microenvironment includes bone marrow stroma, stromal cells and cytokines.

Bone marrow necrosis, myelofibrosis, myelosclerosis, marble disease, bone marrow metastasis of various extramedullary tumor diseases, and various infectious or non-infectious osteomyelitis can all affect blood cell production due to damage to the bone marrow matrix and stromal cells and abnormalities in the hematopoietic microenvironment.

Stem cell factor (SCF), interleukin (IL), granulocyte-monocyte colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF), erythropoietin (EPO), thrombopoietin (TPO), platelet growth factor (TGF), tumor necrosis factor (TNF) and interferon (IFN) all have positive and negative regulatory effects on hematopoiesis. EPO deficiency occurs in cases of renal insufficiency, liver disease, hypopituitarism or hypothyroidism; tumor diseases or certain viral infections can induce the body to produce more negative hematopoietic regulatory factors such as TNF, IFN, inflammatory factors, etc., which can lead to anemia of chronic disease (ACD).

(3) Anemia caused by insufficient hematopoietic raw materials or utilization disorders

Hematopoietic raw materials refer to substances necessary for the proliferation, differentiation, and metabolism of hematopoietic cells, such as proteins, lipids, vitamins (folic acid, vitamin B12, etc.), trace elements (iron, copper, zinc, etc.), etc. Insufficient or impaired utilization of any hematopoietic raw material may lead to decreased red blood cell production.