Red blood cells (RBC - red blood cells) or red blood cells are the largest part of the blood. It is a cell without a nucleus, containing hemoglobin and having an average diameter of 7-8 microns.
Hemoglobin is a red respiratory pigment. The absence of a nucleus suggests that these cells are incapable of division, like others. They are the most important indicator of blood, giving it a red color. Among the cells of the whole organism, they occupy 25%. In 1 mm 3 they contain 4.4β5.5 million. In shape they resemble a biconcave washer, which on a slice resembles a biconcave lens. With this structure, they have a large diffuse surface and can better be saturated with oxygen.
Did you know that the total surface of all red blood cells is 3800 m 2 , which exceeds the surface of the human body by 1,500 times. They are produced due to the special hormone of the kidneys - erythropoietin. Their red brain produces spongy bones - the spine, ribs, and skull.
The erythrocyte index MCV (mean corpuscular volume) indicates the average volume of red blood cells. The indicator is expressed in femtoliters (fl) or cubic microns (ΞΌm 3 = 0.9 mm 3 ). It is calculated using automatic hematological analyzers, in which the counting program is laid down and carried out without involving a person.
Erythrocyte life
Red blood cells are formed from a reticulocyte at the exit of the bone marrow. They reach their maturity within a few hours. The diameter of a mature red blood cell is 7β8 ΞΌm (deviations are permissible up to 9.13 ΞΌm). Due to the lack of a nucleus, they are not able to combine hemoglobin and nucleic acids. Their metabolic rate is low, and they live only 3-4 months - 120 days. Then their hemolysis occurs - this is a natural process of destruction due to aging. The process of hemolysis occurs in the spleen to a greater extent, and to a lesser extent in the liver.
Red blood cell function
The erythrocyte membrane easily passes gases, water, anions, glucose and hydrogen ions. Their function is transport, protective and regulatory. Their main work is participation in gas exchange - delivery of oxygen O 2 from the lungs to the cells of the body and back transportation of carbon dioxide CO 2 with return to the lungs. And they also supply food to cells and bind toxins in the blood, participate in maintaining the balance of acid-base, catalyze many biochemical processes and regulate coagulation.
For each age and gender, there are their own standard content of red blood cells in the blood. These are a kind of highly specialized oxygen cells of the body. For stable operation, their level should be normal.
The rate of red blood cells in the blood
To state the fact of an increase in the volume of red blood cells above the norm, you need to know the established values:
- For an adult male, the norm of red blood cells is from 4.0 to 5.3 Γ 10ΒΉΒ² units per liter of blood, for women - 3.7 to 4.7 Γ 10ΒΉΒ².
- In children up to a year, the concentration of red blood cells changes constantly, every month. And if suddenly, for example, in a blood test, red blood cells are above the norm in a child of two weeks of age up to 6.6 x 1012 / l - this will be the norm.
- Some fluctuations are noted from a year old, but unsharp, they are approaching the values ββof an adult. At 12β13 years of age, their level is similar to that of adults.
If the red blood cells are normal in the analysis, and the hemoglobin is high, this may indicate a thickening of the blood, dehydration of the body, taking certain medications, smoking, staying in the highlands, etc. When receiving a blood test form on the hands, the patient immediately draws attention to the number of red blood cells. But the laboratory not only calculates their number, but also saturation, volume, shape and quality.
There is a magnitude of the width of the expansion of red blood cells (RDW - red blood cell index). Using it, cell volumes, their distribution and range are determined in the range of the largest and smallest blood cells.
With pathologies, red blood cells become heterogeneous. What does this mean? When the volume of distribution of red blood cells is higher than normal, this means that they differ in their diameter.
- normocytes - 7-9 microns - their norm is 85%;
- microcytes - up to 6.9 microns;
- macrocytes - from 8 microns;
- megacytes - from 12 microns.
Erythrocyte anisocytosis is divided into 3 degrees of severity:
- 1 degree - different size in 30-50% of red blood cells;
- 2 degree - 50β70%;
- Grade 3 - more than 70% of the cells are transformed.
When the distribution width of red blood cells is above normal, they live a short life and as a result of their increased destruction, a large amount of iron and bilirubin is formed. For processing, all this enters the liver, as a result, it is overloaded and performs its functions poorly. The spleen increases. Of the symptoms, a yellowish complexion, shortness of breath, arrhythmia are noted.
RDW CV analysis - erythrocyte distribution width. This is the level of cell heterogeneity, in other words. It is measured with a special hematological device and is expressed in%.
Normal ADV for an adult is 11.5-14.5%, for children under 6 months - 14.9-18.7%, after 6 months - 11.6-14.8%. A condition where the width of the distribution of red blood cells in volume is higher than normal is called anisocytosis.
The reasons for the increase in red blood cells
The increase is divided into physiological and pathological. Physiological erythrocytosis can be noted with increased training and intense muscle load, stress and agitation, increased sweating, the use of chlorinated water, vitamin deficiency, living in highlands. The point is the presence of rarefied air depleted in oxygen. The body compensates for this by increased production of red blood cells. By doing this, he makes up for the lack of oxygen so that the tissues do not suffocate from hypoxia. Taking steroids for a long time also leads to erythrocytosis.
Red blood cells are higher than normal - what does it mean with false erythrocytosis? This is a temporary phenomenon that occurs due to dehydration as a result of persistent vomiting or diarrhea, extensive burns. In this case, red blood cells are normal, and in a drop of blood for analysis due to a decrease in plasma hemoglobin will be increased. Such fluctuations are short-term and is associated with a change in blood volume.
The indicator of anisocytosis of erythrocytes above normal is noted in such cases:
- acute hepatic pathology;
- lack of vit. B12, vit. A;
- iron and folic acid deficiency anemia;
- oncology;
- alcoholism;
- leukocytosis;
- hemolytic crisis;
- lead poisoning;
- bone marrow metaplasia and pathologies of the heart and blood vessels.
So, the first cause of erythrocytosis is hypoxia of the body.
Primary and secondary erythrocytosis
By etiology, erythrocytosis is congenital (or primary) and acquired (or secondary).
- Primary - is rare, is hereditary. The etiology becomes the decreased sensitivity of the oxygen receptors of the kidneys, and in parallel with it the increase in erythropoietin. Symptoms in this case: general weakness and fatigue, dizziness and darkening in the eyes, purple color of the skin and mucous membranes, decreased blood coagulation. If untreated, thrombosis may develop.
- Acquired erythrocytosis - occurs as a result of hypoxia.
What happens in the blood with erythrocytosis
With increased demand for red blood cells, their life cycle is reduced. This leads to the fact that the bone marrow receives a signal about the need for replacement, and it activates their production. As a result, erythrocytosis occurs.
Blood in such cases is quickly oversaturated with red blood cells and the work of organs and systems of respiration, blood supply and the brain is deteriorating. This is due to blood clotting. It is accompanied by hepatosplenomegaly and kidney enlargement.
Blood clotting is the cause of heart attacks and strokes. Without the necessary treatment, the outcome can be fatal.
The manifestations of erythrocytosis
Symptoms of erythrocytosis:
- redness of the skin on the face;
- minor but very unpleasant itching;
- increase in blood pressure;
- nosebleeds;
- cephalgia and bouts of dizziness.
Chronic erythrocytosis does not cause noticeable disturbances. The body for a long time itself copes with negative processes, but in the end it is depleted. That is why the reasons need to be identified and treated.
Elevated red blood cells: causes
Red blood cells are above normal - what does it mean? This can not be called a sign of health. This condition can be caused by the following factors:
- Heart defects. Their main negative side is a mixture of venous and arterial blood. At the same time, oxygen transportation is difficult, and the bone marrow begins to intensively produce red blood cells.
- The liver and spleen are involved in the hemolysis of old red blood cells. With oncology, they stop this work, and a large number of mature red blood cells are in the blood. With pulmonary pathologies, cardiac, infections, erythremia, reticulocytes predominate.
- Disease or Aerza-Arrilag syndrome (idiopathic pulmonary hypertension, Escudero disease) is a rare pathology unclear in etiology. It occurs with a frequency of 1 case per 1 million per year. It is characterized by damage to the endothelium and necrosis of the walls of the pulmonary artery, in which vascular resistance and arterial pressure increase automatically. The process occurs quickly and decompensation of the right ventricle with its insufficiency sets in. The condition becomes life threatening.
- Pickwick's syndrome is a type of obstructive apnea that develops with abdominal obesity. This means stopping breathing at night due to a decrease in oxygen in the blood (hypoventilation of the lungs). It is characterized by drowsiness, obesity, hypertension, not treatable, etc.
Less dangerous causes of increased erythrocytosis:
- Insufficient digestive enzymes, therefore, the synthesis of red blood cells increases.
- Hot climate, accompanied by prolonged stress and dehydration.
- Drinking low-quality water.
- Vitamin deficiency as a result of liver dysfunction.
- Smoking, due to excess carboxyhemoglobin, active production of red blood cells occurs.
- Acute childhood infections: diphtheria, whooping cough.
- Itsenko - Cushing's disease. It develops against the background of prolonged use of steroids or excessive synthesis of corticosteroids by the adrenal glands. It is rare.
- Hemoblastosis or polycythemia is a rare type of non-fatal blood cancer.
With proper treatment, the patient can live a very long time. And also an excessively long treatment with herbal preparations of dogrose, nettle, mountain ash (especially) can lead to erythrocytosis. Blood, sugar, potatoes, bananas, animal fats, alcohol, buckwheat and walnuts, soda thicken blood products.
Features of erythrocytosis in children
Red blood cells are higher than normal in children, mainly due to physiological characteristics, pathologies are rare.
In newborns, the concentration of red cells may increase due to intrauterine hypoxia. Factors and causes in children are similar to adults.
Red blood cells above the norm can appear with passive smoking of children, i.e., parents-smokers. The child's body is trying to defend itself and compensates for hypoxia by the production of excess cells. When red blood cells are above the norm in the blood of a child older than a year, this cannot be considered the norm.
Where to start
Erythrocytosis is not a separate disease, but only an indicator and a consequence. Often the beginning rests on hypoxia, so the elimination of the problem begins with it. It should be noted that the analysis obtained has value and significance only when combined with clinical symptoms.
Red blood cell elevation in children
Pathologies when red blood cells are higher than normal in children:
- congenital heart defects;
- bone marrow depression;
- increase in blood pressure in the pulmonary circle;
- blood diseases, especially erythremia;
- obstructive chronic lung disease;
- bronchitis, rhinitis, allergies;
- obesity of the last degree;
- dehydration and exsicosis;
- hypercorticism;
- tumors of the liver and kidneys.
Red blood cells in the urine
Red blood cells in the urine above normal can be for three reasons:
- Prerenal or somatic. Prerenal causes exclude the influence of the kidneys - these are diseases of other organs and systems: thrombocytopenia, hemophilia, infectious intoxications, cervical erosion, prostatitis.
- Renal. These include glomerulonephritis, urolithiasis, pyelonephritis, hydronephrosis and trauma.
- Postrenal - i.e., pathologies of the bladder and ureters, for example, cystitis, stones, and bladder injuries.
Treatment
You need to treat the cause, not the effect. Red blood cells are reduced with blood thinners. A decrease in blood viscosity also reduces red blood cells. For this purpose, 2 groups of drugs are used: anticoagulants and antiplatelet agents.
Anticoagulants lower fibrin synthesis and decrease blood viscosity. In doing so, they inhibit the activity of the coagulation system. There are a lot of them and they differ in their speed of exposure. These are Heparin, Warfarin, Kleksan, Klivarin, etc.
Antiplatelet agents - acts on platelets, preventing them from sticking to blood clots. In doing so, they also thin the blood. TromboAss, Cardiomagnyl, Ipaton, etc.
If erythrocytosis is caused by diseases of the heart, lungs, liver, then the underlying disease is treated. For healing, the doctor also prescribes vitamin and mineral complexes.
Diet basics
Iron-containing foods such as meat, cereals, and some fruits should be excluded from the diet. Tomatoes, beets, cucumbers, eggplant, onions, cabbage, sour berries, ginger, pomegranates, beets, green apples, cocoa thin the blood.
Tap water is completely excluded from drinks (chlorine increases blood coagulation), soda and alcohol (except for a glass of red wine).