What Is Normocytic Anemia

Anemia is considered to be a disorder when there is a decrease in the circulating red blood cell mass to below age-specific and gender-specific limits. One of the most common forms of anemia is the Normocytic anemia.

It is a blood disorder wherein, the blood has normal red blood cells; however, they are lesser in number. In this form of anemia, the mean corpuscular volume (MCV) is within defined normal limits, but the hemoglobin and hematocrit are decreased. This kind of anemia is caused either congenitally wherein the disorder is prevalent when the patient is born or is acquired due to some kind of infection or disease.

When this form of anemia is congenital, the main cause is that the red blood cells in the blood are breaking up. Another similar disorder of the blood due to congenital problem of the red blood cells is the sickle cell disease. When the same disorder is an acquired one then the main cause is a chronic disease like kidney disorder, cancer, rheumatoid arthritis or thyroiditis. The main symptoms of this kind of anemia are tiredness, dizziness or weakness.

When such symptoms arise, the diagnosis of this kind of anemia is usually done through routine blood tests or a complete blood count (CBC). If the CBC indicates correct sized red blood cells however, in lesser numbers, then it is an indication that the patient is suffering from normocytic anemia. In some cases, they could be inherited, and then other family members also need to have their blood tested.

If the main cause of anemia is a chronic disease, then the disease needs to be cured first. In severe cases of this anemia, erythropoietin is prescribed which helps in the bone marrow producing more red blood cells. Statistics indicate that about 44% of men older than 85 years have this kind of anemia. Anemia of chronic diseases is so common that as much as 6 percent of adult patients hospitalized have this disorder.

Statistics also indicate that approximately 4.7 million Americans have anemia whereas population-based estimates indicate that this condition affects 6.6 percent of males and 12.4 percent of females and the prevalence of anemia increases with age. Though it affects mostly the elderly people; the main cause however is not due to old age.

Normocytic Anemia is also common in children. This mainly is due to iron deficiency as well as lead toxicity. Iron deficiency, in its early stages is usually distinguished by a normal MCV and is quite a common cause of mild normocytic anemia in children beyond the neonatal period. Other common childhood normocytic anemia's are the result of acute bleeding, sickle cell anemia, red blood cell membrane disorders and current or recent infections (particularly in younger children).

It is very important that the normocytic disorder is treated as soon as it is detected. The treatment of a normocytic anemia begins with timely identification of its cause. In most cases, the treatment is individualized to the chronic disease it is attached to. Treatments may include avoidance of trigger exposure in patients with hemolytic anemia, correction of iron, folate or vitamin B12 deficiency in patients with mixed disorders, or splenectomy in patients with hypersplenism.

Anemia of chronic disease is the most common normocytic anemia and the second most common form of anemia worldwide, the first being the iron deficiency anemia. In patients with this type of anemia, the MCV is considerably low. This is predominantly due to various reasons, one such being the hypoactivity of the bone marrow resulting in inadequate production of erythropoietin or lack of reaction to erythropoietin, as well as reduced life of red blood cell.

Apart from normocytic anemia found in patients of chronic disease, it is also found in patients with endocrine deficiency. These deficiencies are predominantly due to hypothyroidism, adrenal or pituitary insufficiency or hypogonadism. These deficiencies cause secondary bone marrow failure because of reduced stimulation of erythropoietin secretion.

Another main cause of this kind of anemia is the renal failure wherein anemia crops up in acute or chronic renal failure. Under such circumstances, anemia occurs mainly due to uremic metabolites decreasing the life span of circulating red blood cells and reduces erythropoiesis. Other causes of reduced red blood cell production and subsequent normocytic anemia are bone marrow infiltration, fibrosis, various myeloproliferative diseases and sideroblastic anemia's These rare disorders are generally diagnosed by bone marrow biopsy.