• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Hemato in systemic diseases
 

Hemato in systemic diseases

on

  • 977 views

 

Statistics

Views

Total Views
977
Views on SlideShare
977
Embed Views
0

Actions

Likes
0
Downloads
21
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Hemato in systemic diseases Hemato in systemic diseases Presentation Transcript

    • Hematological aspects in systemic diseases Dr.Tanyarat Jomgeow
    • Hematological manifestation in systemic diseases
      • WBC
      • RBC
      • Platelet
      • Coagulation
      • Fibrinolysis
      • Etc.
      • Stage of disease related
      • with hematopoiesis or
      • blood cells life cycle
      • Clinical manifestation
      • related to hematological
      • manifestation
      • Treatment or drug related to
      • hematological manifestation
    • Chronic disorders
      • * Anemia of chronic disease
      • patients with variety of chronic
      • inflammatory or malignancy
      • Normochromic normocytic anemia or
      • mildly microcytic indices (MCV 75-85 fL)
      • SI, TIBC reduced
      • Serum ferritin normal or raised
      • BM storage iron normal, erythroblast iron reduced
      • ESR, CRP raised
    • Pathogenesis of chronic disorders Inflammatory in chronic diseases Decreased release iron from macrophage Increased release cytokines, IL-6, IL-1, TNF
      • Reduced erythropoiesis
      • Reduced erythropoietin
    • Malignant diseases Hematological manifestation RBC - Anemia chronic disorders, blood loss, iron deficiency, folate deficiency, hemolysis marrow infiltration, marrow suppression from chemotherapy or radiotherapy - Leukoerythroblasic blood film (NRBC and immature granulocyte ) - Polycythemia => tumor of renal, hepatic, cerebellar, uterine
    • Malignant diseases Hematological manifestation WBC - Leukemoid reaction wide spread of tumor necrosis and inflammation Platelet and blood coagulation - Thrombocytosis or thrombocytopenia - Metastasis tumor => DIC, hemostasis failure
    • Autoimmune diseases and other connective tissue disorders Hematological manifestation RBC - Anemia , RBC agglutination, rouleaux formation autoimmune hemolytic anemia chronic disorders iron deficiency by GI bleeding associated with salicylates, anti-inflammatory drugs, corticosteroid WBC - Leukocytosis or leukopenia
    • Hematological manifestation Platelet - autoimmune thrombocytopenia Coagulation - lupus anticoagulant interfere blood coagulation Autoimmune diseases and other connective tissue disorders *LE, ANF/ANA positive, ESR raised
    • Renal diseases Hematological manifestation RBC - Anemia Chronic diseases => chronic renal failure Uremia => inhibit erythroid proliferation => burr cells Dialysis => blood loss, aluminium excess Erythropoietin HUS (hemolytic uremic syndrome) - Microangiopathic hemolytic anemia, fragmented RBC, hematuria - thrombocytopenia
    • Liver diseases Hematological manifestation RBC - Anemia *macrocytic anemia with target cells (increased of choresterol in membrane) *hemolytic anemia in chronic immune hepatitis * Viral hepatitis associated with aplastic anemia Coagulation Deficiency of Vit-K dependent coagulation factor (factor II, VII, IX, X)
    • Infection Hematological manifestation Bacteria Acute bacterial infection - neytrophil leukocytosis, toxic granulation - Dohle bodies, shift to the left of granulocyte Septicemia - severe hemolytic anemia - Leukemoid reaction - DIC
    • Infection Hematological manifestation Viral infection - mildly anemia (acute viral infection) - Infectious mononucleosis , atypical lymphocyte - Some patients develop PNH, TTP-HUS - Aplastic anemia may occur in viral hepatitis, EBV, CMV - Thrombocytopenia and platelet clumping
    • Infection Hematological manifestation Malaria - Hemolysis - DIC - Thrombocytopenia - Chronic disorder => anemia - Splenomegaly