Anemia of spaceflight: Difference between revisions
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==Background== | ==Background== | ||
The anemia of space flight (1% Hb loss per day)<ref>Leach CS, Johnson PC. Influence of spaceflight on erythrokinetics in man. Science. 1984;225(4658):216-218.</ref><ref>Udden MM, Driscoll TB, Pickett MH, Leach-Huntoon CS, Alfrey CP. Decreased production of red blood cells in human subjects exposed to microgravity. J Lab Clin Med. 1995;125(4):442-449.</ref><ref>Alfrey CP, Udden MM, Leach-Huntoon C, Driscoll T, Pickett MH. Control of red blood cell mass in spaceflight. J Appl Physiol. 1996; 81(1):98-104.</ref> It was first described in relation to the Gemini astronauts.<ref> Fischer CL, Johnson PC, Berry CA. Red blood cell mass and plasma volume changes in manned space flight. JAMA. 1967;200(7): 579-583.</ref> | The anemia of space flight (1% Hb loss per day)<ref>Leach CS, Johnson PC. Influence of spaceflight on erythrokinetics in man. Science. 1984;225(4658):216-218.</ref><ref>Udden MM, Driscoll TB, Pickett MH, Leach-Huntoon CS, Alfrey CP. Decreased production of red blood cells in human subjects exposed to microgravity. J Lab Clin Med. 1995;125(4):442-449.</ref><ref>Alfrey CP, Udden MM, Leach-Huntoon C, Driscoll T, Pickett MH. Control of red blood cell mass in spaceflight. J Appl Physiol. 1996; 81(1):98-104.</ref> It was first described in relation to the Gemini astronauts.<ref> Fischer CL, Johnson PC, Berry CA. Red blood cell mass and plasma volume changes in manned space flight. JAMA. 1967;200(7): 579-583.</ref> | ||
*Reports describe from 10% to 15% of Hb decrease from preflight levels within 10 to 14 days of space flight<ref>LeBlanc A, Schneider V, Shackelford L, et al. Bone mineral and lean tissue loss after long duration space flight. J Musculoskel Neuron Interact 2000; 1(2):157–160</ref> | *Reports describe from 10% to 15% of Hb decrease from preflight levels within 10 to 14 days of space flight<ref>LeBlanc A, Schneider V, Shackelford L, et al. Bone mineral and lean tissue loss after long duration space flight. J Musculoskel Neuron Interact 2000; 1(2):157–160</ref><ref>Lang T, LeBlanc A, Evans H, Lu Y, Genant H, Yu A. Cortical and trabecular bone mineral loss from the spine and hip in long duration spaceflight. J Bone Miner Res 2004; 19(6):1006–1012.</ref> | ||
The Anemia may develop due to one or more of the following processes:<ref> | |||
3. Udden MM, Driscoll TB, Pickett MH, Leach-Huntoon CS, Alfrey CP. Decreased production of red blood cells in human subjects exposed to microgravity. J Lab Clin Med. 1995;125(4):442-449.</ref><ref>Tavassoli M. Anemia of spaceflight. Blood. 1982;60(5):1059-1067.</ref> | |||
*Poor erythrocyte production or marrow dysfunction | |||
*Fluid Shifts | |||
**Fluid distributes to a greater extent in the upper body and this distends the carotid and aortic baroreceptors giving the false signal of "volume overload"<ref>Iwase S., Nishimura N., Tanaka K., Mano T. (2020). “Effects of microgravity on human physiology,” in Beyond LEO - human health issues for deep space exploration. Editor Reynolds R. J. (London, UK: Intech Open; ), 1–22. 10.5772/intechopen.90700</ref> | |||
*Low EPO levels | |||
*Abnormally-shaped erythrocytes | |||
*Splenic sequestration | |||
*Shortened RBC lifespan. | |||
==Clinical Features== | ==Clinical Features== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Space medicine}} | |||
{{Anemia DDX}} | {{Anemia DDX}} | ||
==Evaluation== | ==Evaluation== | ||
*Upon return to earth, compensatory fluid shifts may temporarily exacerbate anemia via dilution.<ref>Leach, C. S. & Johnson, P. C. Influence of spaceflight on erythrokinetics in man. Science 225, 216–218 (1984).</ref> | |||
===Workup=== | ===Workup=== | ||
*CBC | |||
===Diagnosis=== | ===Diagnosis=== | ||
==Management== | ==Management== | ||
==See Also== | ==See Also== | ||
*[[Space medicine]] | |||
==External Links== | ==External Links== | ||
Latest revision as of 16:28, 6 November 2024
Background
The anemia of space flight (1% Hb loss per day)[1][2][3] It was first described in relation to the Gemini astronauts.[4]
- Reports describe from 10% to 15% of Hb decrease from preflight levels within 10 to 14 days of space flight[5][6]
The Anemia may develop due to one or more of the following processes:[7][8]
- Poor erythrocyte production or marrow dysfunction
- Fluid Shifts
- Fluid distributes to a greater extent in the upper body and this distends the carotid and aortic baroreceptors giving the false signal of "volume overload"[9]
- Low EPO levels
- Abnormally-shaped erythrocytes
- Splenic sequestration
- Shortened RBC lifespan.
Clinical Features
General Anemia Symptoms
- Most patients begin to be symptomatic at ~7gm/dL
- Weakness, fatigue, lethargy, dyspnea on exertion, palpitations
- Skin, nail bed, mucosal pallor
- Widened pulse pressure
- Jaundice, hepatosplenomegaly (hemolysis)
- Peripheral neuropathy (B12 deficiency)
Differential Diagnosis
Space medicine
- Anemia of spaceflight
- Bone loss of spaceflight
- Contact dermatitis of spaceflight
- Ocular foreign body (microgravity)
- Ear Infections in spaceflight (Otitis Media)
- Ebullism syndrome
- Interpersonal conflicts in spaceflight
- Nitrogen tetroxide toxicity
- Hydrazine toxicity
- Pulmonary disorders of spaceflight
- Sinus congestion (Rhinitis) in spaceflight
- Sinus infection (Acute rhinosinusitis) in spaceflight
- Sleep disorders of spaceflight
- Space adaptation syndrome
- Space dentistry
- Space motion sickness
- Spaceflight headache
- Spaceflight testicular torsion
- Spaceflight urinary retention
- Spaceflight urinary tract infection
Anemia
RBC Loss
RBC consumption (Destruction/hemolytic)
- Hereditary
- Acquired
- Microangiopathic Hemolytic Anemia (MAHA)
- Autoimmune hemolytic anemia
Impaired Production (Hypochromic/microcytic)
- Iron deficiency
- Anemia of chronic disease
- Thalassemia
- Sideroblastic anemia
Aplastic/myelodysplastic (normocytic)
Megaloblastic (macrocytic)
- Vitamin B12/folate deficiency
- Drugs (chemo)
- HIV
Evaluation
- Upon return to earth, compensatory fluid shifts may temporarily exacerbate anemia via dilution.[10]
Workup
- CBC
Diagnosis
Management
See Also
External Links
References
- ↑ Leach CS, Johnson PC. Influence of spaceflight on erythrokinetics in man. Science. 1984;225(4658):216-218.
- ↑ Udden MM, Driscoll TB, Pickett MH, Leach-Huntoon CS, Alfrey CP. Decreased production of red blood cells in human subjects exposed to microgravity. J Lab Clin Med. 1995;125(4):442-449.
- ↑ Alfrey CP, Udden MM, Leach-Huntoon C, Driscoll T, Pickett MH. Control of red blood cell mass in spaceflight. J Appl Physiol. 1996; 81(1):98-104.
- ↑ Fischer CL, Johnson PC, Berry CA. Red blood cell mass and plasma volume changes in manned space flight. JAMA. 1967;200(7): 579-583.
- ↑ LeBlanc A, Schneider V, Shackelford L, et al. Bone mineral and lean tissue loss after long duration space flight. J Musculoskel Neuron Interact 2000; 1(2):157–160
- ↑ Lang T, LeBlanc A, Evans H, Lu Y, Genant H, Yu A. Cortical and trabecular bone mineral loss from the spine and hip in long duration spaceflight. J Bone Miner Res 2004; 19(6):1006–1012.
- ↑ 3. Udden MM, Driscoll TB, Pickett MH, Leach-Huntoon CS, Alfrey CP. Decreased production of red blood cells in human subjects exposed to microgravity. J Lab Clin Med. 1995;125(4):442-449.
- ↑ Tavassoli M. Anemia of spaceflight. Blood. 1982;60(5):1059-1067.
- ↑ Iwase S., Nishimura N., Tanaka K., Mano T. (2020). “Effects of microgravity on human physiology,” in Beyond LEO - human health issues for deep space exploration. Editor Reynolds R. J. (London, UK: Intech Open; ), 1–22. 10.5772/intechopen.90700
- ↑ Leach, C. S. & Johnson, P. C. Influence of spaceflight on erythrokinetics in man. Science 225, 216–218 (1984).