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Question: 11/18/2002
Dr.
Caldwell
I am a consultant for the NJ Department of Health on transfusion
practices and use of blood.
One of my theories is that transfusions are more common in blacks
because of the higher prevalence of anemia. Without adequate screening and
traement they are more likely to be anemic pre and post surgery and
therefore receive a transfusion.
Have you run across any studies that would support this?
Response from Dr. Calwell:
Dear Sir or Madam,
I am unaware of the anemia that you speak of. The Black patients that I
see and care for usually have normal red cell mass reflected in aliquot
samples. There is often leukopenia but it is far from universal and of
no known consequence.
The only unique anemia to young Black Americans is PICA often seen in
young women and it is a variant of iron deficiency anemia. These young
ladies eat: clay, or ice, or starch (ARGO as I remember), paper, cloth
et c. They do not require transfusions but respond to iron by mouth.
I do not even transfuse my patients with sickle cell disease who
usually have hemoglobin concentrations around 7-8 grams unless heavy blood
loss is anticipated...like coronary by pass surgery or radical cancer
surgery.
They seem to tolerate some blood loss without consequence.
In summary, I am unaware of the anemia that you mention in practice or
literature, hence unaware of any unusual transfusion requirements.
Yours truly,
Esly S. Caldwell, II, MD, MPH, FRCP(C), FAAFP, FACP
Question about anemia from a site visitor:
I am interested in
what may be considered idiopathic
anemias, e.g. thallasemia and whether it is
disproportionately found in people of African
American, African descent? Is it in anyway an adaptive
mechanism, as sickle-cell is
thought to be against malaria?
**********
This question has been referred to Dr. Esly Caldwell
for answer, author of the site article on Anemia.
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