некоторые тезисы 30-летней давности:
Arch Intern Med. 1979 Sep;139(9):1053-4.
Severe anemia. Clinical observations in 100 patients with very low hemoglobin levels.
Al-Mondhiry H, Al-Hilali A.
One hundred consecutive patients with hemoglobin concentration less than 3.5 g/dL (hematocrit reading, less than 10%) were admitted to the University of Baghdad Teaching Hospital, Iraq, during a 30-month period. Twenty-eight patients had aplastic anemia, 27 had leukemia or other hemopoietic malignancies, 16 had chronic renal failure, eight had iron-deficiency anemia, eight had hemolytic anemia, seven had thalassemia major, and six had other conditions. Twenty-three patients died within seven days of admission, mostly due to the underlying disease or complications thereof. Heart failure developed in ten patients, and five had retinal exudates and hemorrhages attributed to severe anemia. Arrhythmias and ECG abnormalities were noted in 20 of 68 patients. Blood transfusion was instituted in all but three patients, whose anemia was corrected with specific therapy without blood transfusion. The tolerance of the 100 patients to such severe anemia was remarkable.
P N G Med J. 1979 Dec;22(4):29-36.
Severe anaemia in Port Moresby. A review of 101 adult Melanesian patients with haemoglobin level of 4G/100 ml or less.
Williams G, Naraqi S.
Causes of anaemia in 101 adult Melanesian patients admitted to Port Moresby General Hospital over a 3-year period with haemoglobin levels of 4.0 gms per 100 ml or less were studied retrospectively. Cases of anaemia due to acute haemmorrage were excluded. Iron deficiency was found in 80, haemolysis in 39, megloblastosis in 26 and anaemia of chronic diseases in 5 patients. Anaemia was secondary to multiple causes in 56 and to a single cause in 45 patients. In the group with multiple causes, a combination of iron deficiency and haemolysis was found in 28, iron deficiency and megaloblastosis in 18, iron deficiency, haemolysis and megaloblastosis in 6 and haemolysis and megaloblastosis in 5 patients. In the group with a single cause, iron deficiency was found in 34, anaemia of chronic diseases in 5, haemolysis in 4 and megaloblastosis in 2 patients. Hookworm infestation and malaria appeared to be the major underlying causes of anaemia in the majority of these patients. Three of 45 patients who had received blood transfusions shortly after admission to the hospital died, while there was only one death in the nontransfused group. It is concluded that: i) severe anaemia in Papua New Guinea is commonly secondary to multiple causes; ii) administration of iron and folic acid as well as treatment for malaria and hookworm is a responsible approach when these patients can not be investigated; and iii) blood transfusion does not appear to be necessary in this group of patients despite a very low haemoglobin level.
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