A photo of your FINGERNAILS could

reveal anemia: Scientists create new

cell phone app that can measure red
blood cell count without a blood test
 Some three million Americans develop anemia each year
 When iron and, in turn, hemoglobin gets low in the blood, it can cause
weakness, fatigue and life-threatening oxygen deprivation to body tissues
 People with chronic anemia have to get regular blood tests to check their
hemoglobin levels
 But a new cell phone app developed by Emory University researchers uses
pictures of the color of nail beds to determine red blood cell counts

By NATALIE RAHHAL DEPUTY HEALTH EDITOR FOR DAILYMAIL.COM

PUBLISHED: 11:00 EST, 4 December 2018 | UPDATED: 11:14 EST, 4 December 2018

An innovative cell phone app allows people to test themselves for anemia without even
drawing blood, a new study reveals.

Developed by an Emory University engineering student with a blood disorder, the new
app scans photos taken of the fingernail beds for signs of the amount of hemoglobin -
which help prevent out-of-control bleeding - in the blood.

There are a number of environmental and genetic causes for anemia and for some of
the most serious forms, regular blood tests are required to determine how regularly
blood transfusions are necessary.

But the new app has shown promise to cut out the hassle, cost, and pesky needle prick
to test for anemia.

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A newly-developed cell phone app can tell if you're anemic using photos of your fingernails,
a new Emory University study reveals TH

Anemia is extremely common, affecting about three million Americans each year.

It occurs when someone has a shortage of iron in their blood, a key ingredient to the
production of red blood cells that allow clotting, which prevents us from losing excessive
amounts of blood.

These blood cells also act as a mass transit system for oxygen to reach all of the body's
tissues.

Most of the time, anemia is caused by an iron deficiency which may in turn be the result
heavy menstruation or stages of life when there's a high demand on the blood supply,
like growth spurts or pregnancy.

These temporary bouts of anemia are usually fairly simple to detect, diagnose and treat.

Most people will become pale, weak, tired, short of breath or woozy and sometimes
their tongues will change, becoming swollen and smooth.

Often the issue can be resolved with iron supplements, but if iron deficiency persists,
some may have to have surgery or blood transfusions.

But for some, the condition is chronic and can become life-threatening.

That was the case for Rob Mannino, a biomedical engineering PhD student at Emory in
Atlanta.

He has suffered from a genetic disorder called beta thalassemia for his entire life.

The inherited disease disrupts the production of hemoglobin, the oxygen-transport

protein in red blood cells.

The disease becomes apparent around age two, so since he was a small child,
Mannino's life has had to be scheduled around regular blood tests and transfusions.

'Treatment for my disease requires monthly blood transfusions,' Mannino says.

Those transfusions are rich in hemoglobin, but this can actually introduce an over-
abundance of iron into the blood stream, and that can build up and damage the liver
and heart and create hormone imbalances.

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The app is even able to differentiate between 'milk spots' (3) and a camera flash reflections
(4)

So, ideally, hemoglobin would be regularly monitored so that Mannino would only get
transfusions when absolutely necessary, diminishing or at least delaying this damage.

'My doctors would test my hemoglobin levels more if they could, but it's a hassle for me
to get to the hospital in between transfusions to receive this blood test,' Mannino says.

'Instead, my doctors currently have to just estimate when I'm going to need a
transfusion, based on my hemoglobin level trends.'

Mannino wanted to get rid of the guess work in his medical treatment - and got his
chance when he teamed up with Emory blood disorder expert (and fellow biomedical
engineer), Dr Wilbur Lam.

Mannino made himself a veritable lab rat, meticulously photographing his nail beds as
his hemoglobin levels fluctuated.

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The color underneath fingernails provides a unique visual gauge of red blood cells,
because there is no melanin - the compound that gives skin its pigment - so the color of
that tissue varies with blood composition, rather than skin tone or tan.

Mannino's fingernail selfies 'enabled him to constantly refine and tweak his technology
on himself in a very efficient manner. So essentially, he was his own perfect initial test
subject with each iteration of the app,' said Dr Lam.

The researchers tested the app on four subjects and it accurately judged hemoglobin
deficiencies in people of many skin tones because there is no melanin under fingernails

Dr Lam, Mannino and their research team honed the app's accuracy by expanding the
links Mannino made between his fingernail bed colors and hemoglobin levels by taking
photos and blood tests of another 337 people.

When tested on four people, the resulting photo-based algorithm was as accurate as
bedside blood tests taken at hospitals.

And, Lam says: 'This is just a snapshot of the accuracy right now. The algorithm gets
smarter with every patient enrolled.'

The app won't be sufficiently accurate to diagnose anemia, but once someone knows
they have or are prone to the condition, the researchers are confident it will help people
track their status and know when they need treatment.

'All other "point-of-care" anemia detection tools require external equipment, and
represent trade-offs between invasiveness, cost, and accuracy,' says Dr Lam.

'This is a standalone app whose accuracy is on par with currently available point-of-care
tests without the need to draw blood,' he summarizes.

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The app could be especially useful to women who are pregnant or menstruating and
particularly prone to anemia, the researchers say.

Source: Natalie Rahhal Deputy Health Editor For Dailymail.com. (2018, December 04). A New cell phone
app detects anemia through photos of fingernails. Retrieved January 4, 2019, from
https://www.dailymail.co.uk/health/article-6459183/New-cell-phone-app-detects-anemia-photos-
fingernails.html

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