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Rbc disorders 1
- 1. RBC Disorders Dr.CSBR.Prasad, M.D.,
- 3. Fatigue
- 6. Jaundice
- 10. Delayed mile stones +organomegaly
- 11. Pigmented Gall stones in young Persons
- 12. Ruddy facies of polycytehmia
- 13. Some terms • Anisocytosis • Poikilocytosis – Schistocytes – Stomatocytes – Elliptocytes – Sickle cells – Spherocytes • Polychromasia • Normocyte • Microcyte • Macrocyte • Rouleaux formation • RBC Agglutinates
- 14. Normocyte
- 15. Microcyte
- 16. Macrocyte
- 17. Spherocyte
- 20. Hypochromia
- 21. RBC agglutinates
- 23. The nucleated RBC in the center contains basophilic stippling of the cytoplasm. This suggests a toxic injury to the bone marrow. Such stippling may also appear with severe megaloblastic anemia.
- 25. RBC Indices • HGB • RBC count • HCT • MCV • MCH • MCHC • RDW
- 26. Here is data from a CBC in a person with iron deficiency anemia. Note the low hemoglobin (HGB). Microcytosis is indicated by the low MCV (mean corpuscular volume). Hypochromia correlates here with the low MCH (mean corpuscular hemoglobin).
- 27. The CBC here shows a markedly increased MCV, typical for megaloblastic anemia. The MCV can be mildly increased in persons recovering from blood loss or hemolytic anemia, because the newly released RBC's, the reticulocytes, are increased in size over normal RBC's, which decrease in size slightly with aging.
- 28. This CBC demonstrates findings suggestive of spherocytosis, a condition in which the RBC's are small and round (rather than the normal biconcave appearance) with increased hemoglobin content. This is indicated here by the increase MCHC (mean corpuscular hemoglobin concentration). There is a rare condition known as hereditary spherocytosis. Also, RBC's in the condition of autoimmune hemolytic anemia can also appear similarly.
- 29. Anemias
- 30. Symptoms of Anemia • Fatigue • Shortness of breath • Dizziness • Pale or yellowish skin • Swollen tongue that may appear dark red • Weight loss • Diarrhea • Numbness or tingling in your hands and feet • Muscle weakness • Irritability • Unsteady movements • Mental confusion or forgetfulness
- 31. Anemia Definition: Decrease in hemoglobin concentration below the normal value for the age, sex and for the given individual
- 32. Classification of anemias There are many classifications of anemia • Based on underlying mechanisms • Morphologic characteristics
- 33. Anemias due to BLOOD LOSS Mechanism Specific Examples BLOOD LOSS Acute blood loss Trauma Chronic blood loss Gastrointestinal tract lesions, gynecologic disturbances
- 34. INCREASED RED CELL DESTRUCTION (HEMOLYSIS) Inherited genetic defects Red cell membrane disorders Hereditary spherocytosis, hereditary elliptocytosis Enzyme deficiencies Hexose monophosphate shunt enzyme G6PD deficiency, glutathione synthetase deficiencies deficiency Glycolytic enzyme deficiencies Pyruvate kinase deficiency, hexokinase deficiency Hemoglobin abnormalities Deficient globin synthesis Thalassemia syndromes Structurally abnormal globins Sickle cell disease, unstable hemoglobins (hemoglobinopathies) Acquired genetic defects Deficiency of phosphatidylinositol-linked Paroxysmal nocturnal hemoglobinuria glycoproteins Antibody-mediated destruction Hemolytic disease of the newborn (Rh disease), Mechanical trauma transfusion reactions, drug-induced, autoimmune disorders Microangiopathic hemolytic anemias Hemolytic uremic syndrome, disseminated intravascular coagulation, thrombotic thrombocytopenia purpura Cardiac traumatic hemolysis Defective cardiac valves Repetitive physical trauma Bongo drumming, marathon running, karate chopping Infections of red cells Malaria, babesiosis Toxic or chemical injury Clostridial sepsis, snake venom, lead poisoning Membrane lipid abnormalities Abetalipoproteinemia, severe hepatocellular liver disease Sequestration Hypersplenism
- 35. DECREASED RED CELL PRODUCTION Inherited genetic defects Defects leading to stem cell Fanconi anemia, telomerase defects depletion Defects affecting erythroblast Thalassemia syndromes maturation Nutritional deficiencies Deficiencies affecting DNA B12 and folate deficiencies synthesis Deficiencies affecting hemoglobin Iron deficiency anemia synthesis Erythropoietin deficiency Renal failure, anemia of chronic disease Immune-mediated injury of Aplastic anemia, pure red cell progenitors aplasia Inflammation-mediated iron Anemia of chronic disease sequestration Primary hematopoietic neoplasms Acute leukemia, myelodysplasia, myeloproliferative disorders ( Chapter 13 ) Space-occupying marrow lesions Metastatic neoplasms, granulomatous disease Infections of red cell progenitors Parvovirus B19 infection Unknown mechanisms Endocrine disorders, hepatocellular liver disase
- 36. END
- 37. Dr.CSBR.Prasad, M.D., Associate Professor of Pathology, Sri Devaraj Urs Medical College, Kolar-563101, Karnataka, INDIA. csbrprasad@reiffmail.com