In the circulatory system, various elements come together to perform a single duty, that of delivering nutrients throughout the major organs of the body through blood. Three major elements are contained in blood. First, there is the plasma, which is the fluid portion of the blood (Chapter 7, p. 152). This carries the materials contained within it to their destination. Floating within the plasma are red blood cells, or erythrocytes; they carry oxygen throughout the circulatory system and supply it to the various parts of the body, including major organs like the heart and the brain (p. 152). Finally, platelets are also contained within blood; their primary purpose is to act as a clotting agent, thereby stopping the loss of blood in the case of an injury (p. 157).
The following three individuals are experiencing and dealing with unique circulatory disorders and diseases. In the first case, Lily is a four year old girl who has contracted iron deficiency anemia. This particular disease is caused by either less iron taken into the body, or an increased intake in iron, leaving fewer stores of iron in the body. There are also parasites, such as hookworms and roundworms, who can contribute to the development of iron deficiency anemia. A number of different factors come into play, including insufficient diet and chronic blood loss, that can also cause the disorder.
Lily's symptoms include persistent fatigue, a pale pallor and a lack of appetite. Her diet consists primarily of starches and sugars. This matches up with the symptoms used to diagnose iron deficiency anemia - these include pallor, fatigue, and lightheadedness. Poor appetite is also a sign of the disorder (NPS Medicines Wise, 2010). Given the fact that Lily is constantly tired, there is a real sign that she has iron deficiency anemia.
In Lily's case, there is a great deal that she can do in order to prevent iron deficiency anemia from occurring. Given her poor diet, it is clear that a lack of fruits and vegetables (or any kind of balance) is contributing to the lack of iron in her diet. Iron-rich vegetables and fruits should be added to her diet; this will help her overcome her iron deficiency, and Lily should return to her normal self.
The next patient, Davon, is a young 5-year old black child who may be in danger of carrying sickle cell anemia. Sickle cell anemia is a genetically transmitted disorder, meaning that he must get it from his parents. Since it is homozygous, Davon must inherit the gene from both parents in order to get sickle cell anemia (Ch. 7, p. 156).
In the case study, Davon's symptoms are not stated. However, in a blood test, the nurse can check for sickle cell anemia by examining the blood cells for the crystallization that occurs when hemoglobin S molecules crosslink. Because the mother definitely carries the sickle cell trait, there is a chance that Davon has it, provided his father has the sickle cell trait as well.
Given that this is a genetic disorder, Davon cannot prevent the disease if he has it. There is also no cure for sickle cell anemia; instead, he must have constant care and treatment of his condition throughout his life. With careful control of the anemia, Davon can still lead a long, healthy and comfortable life without the painful crises that often occur as a result of having the disease.
Finally, Spencer has been showing signs of thrombocytopenia in his behavior and health. This condition is evidenced by substantial reduction in platelet count in the blood, leading to prolonged bleeding and a lack of blood clotting. Thrombocytopenia is caused by a deficiency in folic acids or Vitamin B-12; it can also be hereditary. Malignant diseases can dramatically lower the number of platelets that are available for the bloodstream. Autoimmune disorders could also prevent platelets from functioning properly, as well as destroy a greater number of them than is sustainable (Scaradavou, 2002).
The symptoms for thrombocytopenia are consistent with what Spencer is going through. He is finding many different ecchymoses (bruises) all over his body, which are not going away. Red marks are starting to form around his eyes. This is the result of major and minor traumas resulting from everyday life; these bruises are forming and not being healed. Hemorrhaging is occurring around his eyes, forming petachiae, as evidenced by the red marks. The ecchymosis that is found on his body is a result of the same phenomenon, only elsewhere (p. 158). These symptoms alone secure Spencer's diagnosis of thrombocytopenia.
In order to treat his thrombocytopenia, a number of things can be done; first, the underlying cause must be determined. Autoimmune disorders must be dealt with (if they can be) in order to increase platelet count. Adding more folic acids or vitamin B-12 into Spencer's diet will also help him create more platelets with which to fight hemorrhaging. Over time, and with significant bed rest to limit the amount of trauma his body experiences, the bruises will go away, and his platelets will be back to normal.
Of course, there are dramatic measures that could be taken in the event that milder treatments do not work. Those who become very sick as a result of the thrombocytopenia may end up having their spleen removed; corticosteroids are also another step in the process, as it can stop hemorrhaging in patients (p. 158). There are also chronic instances thrombocytopenia that will never fully go away; the individual attacks can be treated, but those with this kind of chronic disorder will intermittently encounter this kind of hemorrhaging.
References
Mulvihill, M.L., Zelman, M., Holdaway, P., Tompary, E., & Raymond, J. (2010). Human
Diseases: A Systemic Approach (7th ed.). Pearson Education.
NPS Medicines Wise. (2010). NPS News 70: Iron deficiency anaemia. Retrieved November 5,
2010.
Scaradavou, A (2002). "HIV-related thrombocytopenia". Blood Reviews 16 (1): 73–6.
