The norm and deviations from it of erythrocytes in children. Causes of a decrease in red blood cells in a child, functions and correction of indicators If a child has low red blood cells

Blood is internal environment organism, consisting of formed elements and plasma. Erythrocytes represent a significant part of blood cells, the main function of which is respiratory. Their decrease or increase in the blood is not a disease, but indicates disorders in the body in children. Sometimes it is physiological in nature, in other cases it requires additional examination and treatment.

Red blood cells are formed in the bone marrow under the influence of erythropoietin. The cytoplasm of an erythrocyte is 96% filled with hemoglobin, consisting of a protein complex and iron. Life cycle cells in the peripheral blood of a newborn is 12 days, by the age of 14 it increases to 2 months as in an adult.

The main functions of erythrocytes:

Respiratory. Red cells carry oxygen from the alveoli of the lungs to the tissues of the body. On the way back, erythrocytes take carbon monoxide (CO 2) from the cells and return to the respiratory organs. In addition, they provide the delivery of enzymes, amino acids, peptides, fats, vitamins, minerals, hormones and other essential substances.
Protective. Erythrocytes are involved in nonspecific (innate) and specific (acquired) immunity. In addition, they prevent bleeding in case of damage to the walls of blood vessels, forming a "red blood clot".
Regulatory. Blood cells provide a relative constancy of the ionic composition of the plasma, regulates blood pH, water-salt balance.

Norm in the blood

The rate of erythrocytes in peripheral blood in children depends on age. Study Protocol clinical analysis contains information about the content of red cells, expressed in terah per liter (10 x 10 12 /l).

Elevated red blood cells in the blood of a newborn baby are due to a lack of oxygen during childbirth.

Exceeding the norm

Erythrocytosis is relative and absolute. Relative erythrocytosis occurs:

With loss of fluid during vomiting,;
At ;
With extensive burns;
Staying in a room with low air humidity;
Under the influence of nicotine (the presence of a child with smoking parents);
When replacing drinking water carbonated drinks, as well as the intake of water with a large amount of chlorine-containing substances.

At the same time, the erythrocytes in the peripheral blood of the child do not increase, but the plasma volume decreases.

With an absolute increase in red cells, there is an increase in erythropoiesis in the hematopoietic organs. True or absolute erythrocytosis for the main reasons is divided into primary and acquired. True polycythemia(synonyms: erythremia, Wakez-Osler disease) is characterized by an increased production of red blood cells. The main causes of increased erythropoiesis are:

The action of ionizing radiation;
Bone marrow damage by toxins;
Heredity.

True erythremia is characterized by a long benign course. Rarely goes into, ending in death.

Acquired erythrocytosis appears with the following pathologies:

At , flowing from . The lack of oxygen stimulates the production of red blood cells by the bone marrow.
With congenital, associated with stenosis of the opening of the pulmonary trunk, flowing with cyanosis, shortness of breath (tetralogy of Fallot).
. Erythrocytes are elevated in a child due to increased stimulation of the bone marrow by corticosteroid hormones.
Hypernephroma. Erythrocytosis is provoked by increased formation in the kidneys of a substance that stimulates the formation of red cells (erythropoietin).

Clinical manifestations

There are no symptoms with relative erythrocytosis. At viral infection or gastrointestinal diseases clinical manifestations will match the underlying disease.

However, absolute erythrocytosis is characterized by the following symptoms:

Change in skin tone according to the type of erythrocyanosis, redness of the eyes;
Headache and;
General malaise, weakness;
promotion blood pressure;
Pain in the region of the left hypochondrium due to hyperplasia of the spleen;
Joint pains;
Hearing and vision impairment;

In the last stage of the disease, they join severe complications(thrombosis coronary vessels, peptic ulcer stomach, ).

The danger of erythrocytosis

The excess of erythrocytes more than the standard value increases the viscosity of the blood. Violation of blood flow contributes to the formation of blood clots in the vessels, which leads to a number of serious diseases:

Acute circulatory disorders in the brain ();
Dilated cardiomyopathy - disorders of the heart, associated with an increase in the volume of circulating blood.

What to do

If the increase in erythrocytes is more than 8.0 x 10 12 /l, repeat the analysis to exclude a laboratory error. If the results are reliable, further research is needed:

Definition ;
Hematocrit values;
Content and ;
Erythrocyte sedimentation rate (ESR).

Of great importance in this disease is the morphological structure of red cells. The presence of anisocytosis (cells of different sizes) in the absence of iron deficiency is inherent in erythremia. On severe course disease indicates high content platelets and leukocytes. ESR indicators reduced and equal to zero. In addition to the general analysis, they appoint:

Biochemical study of blood.
Sternal puncture (bone marrow examination).
Trepanobiopsy ( histological examination material from the ilium), a method that provides reliable information about the main symptom of the disease - three-growth hyperplasia.

Based on the results and examination of a small patient, the doctor prescribes treatment. During treatment, the pediatrician recommends adhering to the following rules for caring for the baby:

Arrange the right water regime to kid. Exclude carbonated drinks, use clean drinking water for drinking;
Ensure a balanced and balanced diet with a predominance of fresh fruits and vegetables. Supplement the diet with lemons, berries, beets, garlic - blood thinning products;
Ventilate the room more often, monitor the humidity of the air.

Types of erythropenia

Erythropenia is relative and absolute:

Relative. Reduced red blood cells in the peripheral blood of a child are observed with the introduction of a large volume of fluid into the body. This condition is not dangerous for the health of the baby.
Absolute. Insufficiency of the formation of red blood cells in the bone marrow, or their hemolysis leads to a decrease in red cells in the blood.

Table number 2

The lower value of the norm of erythrocytes in the blood in children in different age groups

The main causes of a decrease in red blood cells are blood loss and hemolysis. Reduced blood cells in the presence in the body autoimmune diseases, infections, intoxication, chronic inflammatory processes. Most children are diagnosed reduced level erythrocytes in the following types of diseases:

iron deficiency anemia.
Addison-Birmer disease (with a lack of vitamin B 12).
B 12 (folic) - deficient (megaloblastic) anemia.

The list of symptoms for these diseases is:

Increased fatigue;
Irritability;
Constant sleepiness;
Headache and dizziness;
Tachycardia;
Noise in ears;
Perversion of taste (tendency to use chalk, clay and other substances);
Dyspnea;
Violation of vision, flickering of "ants" before the eyes.

Objectively, pallor of the skin is observed, with a lack of vitamin B 12 there is a lemon-yellow hue, puffiness of the face.

Erythropenia in a child leads to oxygen deficiency in the body, which disrupts the work internal organs. Lack of oxygen in children leads to developmental delay, decreased immunity, and problems with blood clotting.

Treatment

If the child has complaints about constant fatigue, pallor of the skin of the face is noted, consult a pediatrician. To clarify the type of anemia, the doctor prescribes a number of laboratory tests:

The average volume of erythrocytes in the blood (with anemia is lowered);
erythrocyte indices;
Hematocrit.

When establishing a diagnosis, the morphological features of erythrocytes are also important. Example: for iron deficiency anemia characteristic erythrocyte index (anisocytosis) and anisochromia (heterogeneity of cell color) with reduced hemoglobin. Normally, these indicators are absent. The pediatrician prescribes treatment based on the tests. With erythropenia associated with other diseases, the cause of the underlying disease should first be eliminated.

It is not always a disease, however, parents should consult a pediatrician so as not to miss a possible disease. Only an additional diagnostic examination will give a complete picture of the blood and help to make an accurate diagnosis.

An indicator of red blood cells in a general blood test can tell a lot about a person's health. For parents, it is especially important whether the red blood cells in the child's blood are normal. Given the characteristics of the child's body, the data on such an important parameter change several times until they reach the indicators characteristic of an adult.

If we take into account the fact that it is low or high red blood cells that are often the first symptom of a beginning pathological process results should not be ignored. The reasons for deviations in one direction or the other may be different, and not always dangerous, so there is no need to panic ahead of time. Only a thorough examination will allow you to dismiss or confirm the diagnosis, and this is best done by an experienced doctor.

Properties and functions of red blood cells

Erythrocytes are called formed elements of the blood that do not contain nuclei. They form in red bone marrow, their life expectancy in children in the early neonatal period is 12 days. This figure begins to increase rapidly and in infancy reaches the indicators characteristic of an adult - 120 days.

For the body, the optimal number of red blood cells means a lot. Red blood cells perform several functions at once:

They carry carbon dioxide from tissues and organs to the lungs, where they are enriched with oxygen and carry it throughout the body. The unique system of the cell structure (a disk with convex edges) contributes to the most complete enrichment of the formation with gas during its passage through the blood vessels.
Unique cells support acid-base balance blood environments.
They take part in some enzymatic processes, carry amino acids through the tissues.
In addition, erythrocytes in the body of children and adults carry out protective function. They take part in the processes of adsorption of toxins, triggering immune responses.

After the cell has completed all the functions, it is destroyed in the spleen or liver. At the same time, it is the bone marrow that is responsible for ensuring that the rate of the indicator is always maintained and does not shift to the sides.

The norm of erythrocytes in different periods of childhood

The number of red blood cells is indicated in the general blood test, for which a capillary biological substance is taken (i.e., a finger is punctured). The greatest number of cells is observed in the blood of children immediately after birth and is approximately 5.4 1012/l. By the end of the first month of life, this indicator decreases to 4.7 1012/l. With minor changes, these parameters are stored until the child reaches adolescence– from 4.2 1012/l to 4.8 1012/l. Older children are already characterized by a division by gender. For boys over 14 years old, the norm is 5.2 1012 / l, for girls - 4.8 1012 / l.

Tip: Anemia caused by a reduced red blood cell count, contrary to traditional belief, is not always the result of an improper or inadequate diet. Before changing your diet, it is better to consult a doctor, the causes of the condition may be related to the characteristics of the body, which requires medical correction of the condition.

The initial increase in the indicator is explained by the need to compensate for the lack of oxygen, which is characteristic of the birth process. A condition is considered critical when the erythrocytes are reduced to 1.0 1012/l, and immediate medical correction is necessary here.

Going to take tests, it must be taken into account that the release of emotions, stress and physical activity contribute to an increase in the number of red blood cells in the test material. Also, the norm can be violated upward by the need to rise to a considerable height. This should be taken into account by residents of the highlands who have moved to new conditions.

What does an elevated erythrocyte count indicate?

A condition in which red blood cells are elevated is called erythrocytosis. This phenomenon can be absolute or relative.

Absolute erythrocytosis is much more dangerous than relative and is the result of increased production of red blood cells by the bone marrow. Its primary form is characterized as a malignant disease of the blood. The secondary form indicates the presence of a certain organ pathology and disappears as effective therapy is carried out.
Relative erythrocytosis means that the number of erythrocytes has increased against the background of a decrease in the liquid part of the blood, i.e. her thickening. The production of red blood cells by the bone marrow remains unchanged.

The main causes of secondary absolute erythrocytosis are associated with hypoxia caused by chronic lung diseases, congenital or acquired heart defects. The phenomenon can also be triggered by an excess of the course of taking hormones in the treatment of Cushing's syndrome and adrenal tumors. Relative erythrocytosis occurs in children on the background of prolonged diarrhea, profuse vomiting, burn disease, edema, accumulation of fluid in the pleural cavity.

What does the low score mean?

If the erythrocytes in the blood are lowered, this indicates the development of erythrocytopenia. This pathological phenomenon is provoked by massive blood loss or the rapid destruction of erythrocytes as a result of the action on children's body poisons or toxins. But most often the norm is not maintained in children due to the development of anemia.

Anemia - pathological condition, which is characterized by a decrease in the number of erythrocytes and the level of hemoglobin in a unit of blood. The main causes of the development of the disease are blood loss, a violation of the process of cell formation, a violation of the process of cell destruction (it happens too rapidly). Children most often have problems with blood formation, which slows down due to a deficiency in the body of iron and vitamin B12. In rare cases, these components are not absorbed, usually the norm of their content in the baby's food products is simply not maintained.

If the red blood cells are elevated, this can often be found out only after a routine analysis has been made. As for the reduced indicator, in children it manifests itself in the form of weakness, irritability or fatigue. In cases where the norm is not maintained significantly, dizziness and tinnitus, headaches, and visual disturbances join the symptoms presented.

In infants, behavior most often suffers, there is a decrease in appetite. A striking symptom of anemia is a distortion of taste. This means that the baby is ready to eat chalk, sand, earth or raw meat (in this way the body tries to neutralize the causes of the condition and replenish the reserves of iron and other trace elements).

Any of these pathological conditions requires an immediate response. If you delay with the start of treatment, hoping that everything will normalize by itself, you can lead to a significant weakening of the child's immunity, the development of crisis complications. All manipulations aimed at normalizing the content of red blood cells in the blood of a child should be carried out under the strict supervision of a physician. Even the diet and application of proven folk remedies must be agreed in advance with medical worker.

Many mothers are aware of such a problem as red blood cells in the urine of a child, and here is the content of these cells substances in the blood, few know. So, below you will find out what to do if the red blood cells are low or, on the contrary, high in the blood of a baby, what is their norm in general.

red blood cells- formed elements of blood that do not contain a nucleus. They are formed in the red bone marrow, their life expectancy in the bloodstream varies depending on the age of the child and some other features.

In the early neonatal period, this period is 12 days, then gradually increases and starting from infancy is 120 days, as in adults.

Functions of erythrocytes:

carry the necessary oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs;
participate in the regulation of the acid-base state;
participate in the adsorption of lipids, amino acids, antibodies, toxins, in certain enzymatic processes.

The number of erythrocytes is determined in capillary blood, which is included in general analysis blood. The amount is measured in 1012/l or T/l (terra per liter).

The normal number of red blood cells in a child has age-old differences:

neonatal period (1-28 days of life): 5.4 1012/l (at the beginning of the period); 4.7 1012/l (at the end of the period);
from infancy to 14 years - 4.2-4.8 1012/l;
over 14 years old: boys - 5.21012/l; girls — 4.81012/l.

Thus, the greatest red blood cell count observed immediately after the birth of the child. This allows you to compensate for the lack of oxygen in the body of the fetus during childbirth.

critical number erythrocytes, that is, dangerous for the life of the child, there are 1.0 1012 / l. This condition needs immediate medical treatment.

In addition, emotional or stress factors can also affect the number of red blood cells. They help boost cells.

It should be noted that the rise to a height is accompanied by a very significant an increase in the number of red blood cells. Ethos is associated with a decrease in the partial pressure of oxygen in the air. For residents of the highlands, such changes are completely normal.

Erythrocytosis is an increase in the number of red blood cells in the blood. In pathology, erythrocytosis is absolute and relative. Absolute erythrocytosis results from enhanced erythropoiesis(the formation of red blood cells in the bone marrow), and it is much more dangerous than relative.

Primary absolute erythrocytosis called erythremia and is a malignant disease of the blood.

Secondary absolute erythrocytosis develops against the background of a certain disease and disappears after its complete cure in a child.

Most common cause such a condition is hypoxia at chronic diseases lungs ( obstructive bronchitis, pneumosclerosis, emphysema), congenital and acquired heart defects (Fallot's triad, stenosis pulmonary artery etc). Also, erythrocytosis can be caused by an excess of glucocorticoid and other hormones in adrenal tumors and Cushing's syndrome.

Relative erythrocytosis characterized by an increase in the content of erythrocytes against the background of thickening of the blood, a decrease in the amount of its liquid part. Erythropoiesis remains unchanged.

This condition may be accompanied by an increase in edema, accumulation of pleural and ascitic fluid, diarrhea, vomiting, and burn disease.

Decreased levels of cells in the blood

Erythrocytopenia- a decrease in the number of red blood cells in the blood. Such a pathological condition is observed after significant blood loss, with anemia and after massive hemolysis.

The latter may be caused by hepatotoxic or other strong poisons or be a manifestation of hemolytic anemia.

Anemia- This is a condition characterized by a decrease in the number of red blood cells and hemoglobin content per unit volume of blood.

In accordance with the reasons for the development of anemia, the following groups are distinguished: as a result of blood loss, as a result of impaired hematopoiesis and as a result of increased blood destruction ( hemolytic anemia).

It is especially worth paying attention to the second group of anemias. Such anemia is most often found in children, because it is associated with iron deficiency, vitamin B12 or folic acid. Often this happens due to insufficient intake of the relevant components into the child's body, inconsistencies in the amount of food consumed.

The main complaints about well-being in patients with anemia are weakness, fatigue or irritability.

With significant anemia, phenomena such as dizziness, noise in ears, headache. Characteristic are visual disturbances in the form of "ants" before the eyes, reduced visual acuity.

Regarding nutrition, in patients with anemia, there is a significant decrease in appetite, possible cases anorexia.

Also, a specific feature of this particular pathology is a distortion of taste. The child is able to eat inedible items such as chalk, earth, sand, raw meat.

Outwardly, changes in the skin and its derivatives attract attention.

The skin becomes dry, pale, hair brittle. Children are difficult to tolerate physical activity, which accompanied by shortness of breath and a significantly increased heart rate in your baby.

On auscultation of the heart, a systolic murmur and a weakening of the heart tones are heard. With a long course of the disease in children early age neurodevelopmental delay is possible.

Children also have prolonged increase body temperature in the range of 37-37.5ºС (subfebrile condition). Significantly in anemia suffering the immune system , which is accompanied by frequent inflammatory processes.

However, the children's body has a high restorative capacity, therefore, with timely and effective treatment can completely eliminate the effects of anemia.

Erythrocytosis in children is often detected during standard tests. An increased number of red cells may indicate chronic diseases or be a variant of the norm for a particular individual. If the red blood cells are elevated in a child, finding out the reasons for such a blood picture requires additional tests on the level of hormones, other abnormalities in the body.

What are erythrocytes

Functions of oxygen saturation, transportation nutrients red blood cells produced by the bone marrow perform in the body. The body uses the liver and spleen to destroy "old" cells. If the red blood cells in the blood of a child are elevated, this means that the number of red blood cells is beyond the medical norm. This indicator should mean what is the concentration of hemoglobin on this moment along with the relative proportion of different cells.

The norm of erythrocytes in children

Elevated red blood cells in the blood of a child are determined by establishing their number relative to the norm. The occurrence of a deviation may not be reflected in the analysis picture immediately, so the resulting indicator must be rechecked after a while. Exceeding the norm is permissible to explain physiological cause given the patient's history. The standards are as follows:

Erythrocytes in the blood are increased in a child

The lack of red cells is observed in anemia, some inflammatory diseases, and an increase in erythrocytes in the blood of a child can be interpreted in different ways: they take into account the general history, the predominance of certain foods in the diet. Minor erythrocytosis is sometimes caused physical activity. Pathologies are spoken of when an excess of red cell levels of more than one is diagnosed.

Types of erythrocytosis

The increased content of erythrocytes in the blood of a child is relative or true. The first option means that the amount of liquid - plasma is relatively small. This occurs due to dehydration, stress, in overweight people, as a result of other reasons that do not increase the actual number of red cells. The second option implies a high level of erythrocytes, which is often combined with a high sedimentation rate. This is evidence of the presence of infections, dangerous diseases.

Symptoms

High relative erythrocytosis is not manifested by any characteristic features, passes as the state of the organism, environmental conditions change. True doesn't count independent disease, therefore, the symptom complex will be given by those diseases that cause an increase in the number of red cells. Among them may be:

pain in the limbs - fingers and toes often suffer;
headaches, characteristic evening, night;
urinary disorders, discomfort in the back - with kidney disease;
shortness of breath, shortness of breath - with diseases respiratory tract, in infants sometimes associated with passive smoking;
hyperemia or cyanosis of the skin - associated with manifestations of heart defects;
sudden weight loss, weakness - make you suspect oncological disease, require especially close attention pediatricians, a complex of analyzes.

Causes

If a single result of the analysis showed that the red blood cells are slightly increased in a child, you need to understand the factors that provoked this condition. Among the reasons there are completely harmless, pointing to increased amount blood cells as a variant of the norm. The general meaning of erythrocytosis is that more red cells are needed to transport oxygen. High level hemoglobin in itself is not a disease, but a reason to beware. Among the reasons elevated red blood cells doctors call:

Sports activities, especially swimming.
accommodation in highlands where there is little oxygen - hemoglobin rises to more efficiently supply the brain.
Recent infection.
Erythrocytosis often occurs in diseases of the kidneys, liver, respiratory tract.
Sometimes it indicates heart defects, oncological processes of the liver, kidneys, spinal cord.

What is dangerous erythrocytosis

A pronounced excess of hemoglobin is dangerous for the child's body. Pain in the muscles and limbs often develops due to the increased load on small capillaries. Headaches, high blood pressure may occur. Related problems–dehydration, lack of vitamins, have a negative impact on the health of the baby. In children, the spleen enlarges, as it is under increased stress. Skin acquire a pronounced red tint.

Largest number cells moving in the blood are represented by erythrocytes (RBC). These are biconcave discs filled with a complex hemoglobin chromoprotein. The main function of erythrocytes is the transport of nutrients, biologically active enzymes, oxygen, amino acids to tissues, the reverse transport of waste products of cell metabolism, mainly carbon dioxide. Important role RBC play in maintaining the reserve alkalinity of the blood, necessary for the flow of metabolic processes. When red blood cells are lowered in the blood, the body suffers from hypoxia (), and tissues from a lack of nutrients and an excess of their own toxic waste products.

Norm

The number of RBCs is determined in . If a lack of red blood cells is found in the blood, then it is accompanied by a deficiency of hemoglobin. The standardizing specialists agreed that the following values should be considered in the sex and age context:

For women - 4.2±0.5*109 /ml;
For newborns - 4.95 ± 1.65 * 109 / ml;
For children >1<13 лет4,1±0,6*109 /ml;
For men 4.7±0.8*109/ml.

Excessive excess of the concentration of erythrocytes was called "erythrocytosis", and the same deviation with a minus sign - "erythropenia". When red blood cells are lowered in a man or woman, this means that a person has erythropenia, in other words, anemia or anemia.

Causes of erythropenia

There are the following reasons for the low level of red blood cells in the body:

Pregnancy is a physiological condition that allows for slight erythropenia. Erythrocytes in the blood of a woman are lowered during pregnancy, due to the retention of fluid in the bloodstream. It turns out the effect of "diluted blood" - the concentration of all elements is slightly below normal.

If the number of red blood cells falls below 3 * 109 / ml, an additional examination is carried out and measures are taken to restore the number of cells, for example, iron-containing preparations are used.

In a child, a low content of red blood cells in the blood should be considered an alarm signal. Children tend to hide the injury, leading to hidden bleeding. In addition, erythropenia in children may be due to genetic abnormalities.

Low red blood cells in newborns can result from. The development of the disease is facilitated by the destructive effect of maternal antibodies on fetal cells through the placenta and breast milk. In babies, yellowness of the mucous membranes and skin develops.

Symptoms

Symptoms depend on the form of anemia, the severity of its course. In the chronic course of anemia, the fall in hemoglobin, the number of cells occurs gradually, the body adapts to new conditions of existence.

There are the following symptoms of anemia:

. Decreased muscle mass;
Decreased libido in an adult male;
Headache;
Prostration. Weakness. fainting;
Paleness or yellowness of the skin and mucous membranes;
with anemia;
The appearance of mucosal defects in the mouth, throat, rectum. Carious processes on the teeth. gum changes;
Secondary immunodeficiency. Vulnerability to colds and fungal infections. Thrush, stomatitis;
Dark urine;
Poor wound healing. Susceptibility to suppuration;
Spontaneous bruising;
Suddenly can go;
Increased excitability;
Cracking in the corners of the lips;
Brittle nails;
Perversion of appetite - addiction to clay, earth, snow;
Lag in the growth and development of children.

Symptoms of anemia in an adult are external and internal.

Diagnostics

Diagnosis of anemia in humans is based on laboratory tests and clinical symptoms. The only criterion by which it is possible to assert the presence of symptoms of anemia is considered. Moreover, the severity of anemia is determined by the concentration of Hb. A mild degree of anemia (in an adult and a child) is considered> 9%, severe -<7%.

With erythropenia, the following changes in the analyzes are observed:

The fall in the number of erythrocytes in men is below 4 * 1012 / l, in women below 3.5 * 1012 / l;
Hypochromia. below 0.85;
Detection of red blood cells of different sizes and shapes;
Deviations from the norm in the number of reticulocytes (predecessors);
Falling iron levels;
High ESR.

Treatment

The mild stage of erythropenia does not require medical treatment, and is limited to nutritional correction. Even with the development of moderate or severe anemia, eliminating the cause of the disease eliminates the need for medication.

Foods high in iron - chickpeas, beans, beans, oatmeal, pumpkin seeds, flax seeds, chia, dark chocolate, spinach, peanuts, almonds, dates, raisins, dried apricots, etc.

If the doctor believes that it is impossible to cure anemia without the use of medications, he prescribes drugs that stimulate the bone marrow. These drugs include iron preparations, cyanocobalamin, folic acidum, multivitamins.

If the use of iron sources and B-group vitamins does not lead to recovery, erythropoietins, anabolics, glucocorticosteroids, and other drugs are used.

The use of medications should be accompanied by a correction of the diet and the abandonment of bad habits - smoking, drinking alcohol.