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This a common side effect of cytotoxic drugs. Effective haemoglobin synthesis and red blood cell production also depends on the action of a growth factor, erythropoietin, produced by the kidneys. In chronic renal failure lack of this growth factor results in anaemia. Replacement therapy is by intravenous or subcutaneous injection of epoetin. Increased destruction of erythrocytes, or haemolytic anaemia, occurs if erythrocytes are broken down prematurely and can be due to haemoglobin defects, abnormal enzymes, membrane defects, poisons or infections, incompatible blood, autoimmune disease or hereditary disease.

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Myasthenia gravis is an autoimmune disease where acetylcholine receptors at the alprazolam online cheap junction are progressively destroyed. This interferes with muscle contraction causing muscle weakness and fatigue. In many patients, removal of the thymus gland can induce remission of the disease. Drug therapy includes the use of anticholinesterase drugs, anti-inflammatory corticosteroids and immunosuppressant drugs in resistant cases. The first two case studies are about hypothetical patients who might be seen in the podiatry clinic.

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