Fewer red blood cells

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Laurie Strongin is holding out hope for many critically ill children.

In honor of her son, Henry, who died in 2002 at age 7 of Fanconi anemia, she started the Hope for Henry Foundation, a nonprofit organization that brings laughter and smiles into the lives of children with life-threatening illnesses.

With the release of “Harry Potter and the Half-Blood Prince,” Ms. Strongin, who lives in Northwest, hosted Harry Potter book parties at Georgetown University Hospital in Northwest and Hackensack University Medical Center in New Jersey.

“Henry’s disease was different than some of the other anemias because it was absolutely life-threatening,” Ms. Strongin says. “It was as serious as cancer.”

Although the average person usually associates anemia with low iron levels, there are close to 100 different types of anemia with many causes, including serious disease, blood loss, genetic predisposition, side-effects of medication or vitamin deficiencies. Depending on the form of the disease, it can range from mild to severe.

Although there are differences in the severity of the anemias, they all lead to the same endpoint — the number of red blood cells in the body decreases, says Dr. Sophie Lanzkron, director of the Sickle Cell Center for Adults at Johns Hopkins Hospital in Baltimore.

“If you’re anemic, you shouldn’t just let it go,” Dr. Lanzkron says. “You can’t just say, ‘I’ve been anemic all my life.’”

Generally, anemia is caused by inadequate production or increased destruction of red blood cells, says Dr. Lawrence Lessin, medical director of the Washington Cancer Institute at Washington Hospital Center in Northwest.

In patients with deficient amounts of iron, vitamin B12 or folic acid, red blood cell formation usually is impaired, he says.

Red blood cell formation also can be suppressed by cancers, infection, inflammatory diseases, chemical radiation, medication, and viruses, such as HIV, hepatitis and cytomegalovirus.

Fanconi anemia, an inherited anemia, involves the failure of bone marrow to produce all types of blood cells. Many children with the disease have bone marrow transplants.

Increased red blood cell destruction, which generally is not improved by additional iron supplementation and can possibly make it worse, can be seen in association with sickle cell disease, Cooley’s anemia, spherocytosis, hypersplenism and parasites, such as malaria.

“It’s an extremely complicated issue, but a very common problem,” Dr. Lessin says. “Each time you find a case it leads you to look further to the true root cause.”

By American standards, more than half the people in the world are anemic, Dr. Lessin says. People in Third World countries especially suffer from iron loss or uncompensated blood loss, for reasons such as giving birth or parasites.

However, in the United States, at least 25 percent of people entering the hospital are anemic, and physicians must treat the underlying disease to relieve the anemia, Dr. Lessin says. Diagnosis is made through a simple blood test.

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