RBC Disorders Dr.CSBR.Prasad, M.D.,
Clinical presentations
Fatigue
Pallor / Anemia
Spoon nails [Koilonychia]
Jaundice
Prolonged Neonatal jaundice
Hepatosplenomegaly
Hepatosplenomegaly
Delayed mile stones +organomegaly
PigmentedGall stones in    young  Persons
Ruddy facies     ofpolycytehmia
Some terms• Anisocytosis• Poikilocytosis    –   Schistocytes    –   Stomatocytes    –   Elliptocytes    –   Sickle cells  ...
Normocyte
Microcyte
Macrocyte
Spherocyte
Anisopoikilocytosis
Polychromatic cells
Hypochromia
RBC agglutinates
Rouleaux formation
The nucleated RBC in the center contains basophilic stippling of the cytoplasm. This suggests atoxic injury to the bone ma...
Sickle cell anemia
RBC Indices•   HGB•   RBC count•   HCT•   MCV•   MCH•   MCHC•   RDW
Here is data from a CBC in a person with iron deficiency anemia. Note the lowhemoglobin (HGB). Microcytosis is indicated b...
The CBC here shows a markedly increased MCV, typical for megaloblastic anemia. TheMCV can be mildly increased in persons r...
This CBC demonstrates findings suggestive of spherocytosis, a condition in which theRBCs are small and round (rather than ...
Anemias
Symptoms of Anemia •   Fatigue •   Shortness of breath •   Dizziness •   Pale or yellowish skin •   Swollen tongue that ma...
Anemia             Definition:Decrease in hemoglobin concentrationbelow the normal value for the age, sex      and for the...
Classification of anemiasThere are many classifications of anemia• Based on underlying mechanisms• Morphologic characteris...
Anemias due to BLOOD LOSS Mechanism            Specific Examples BLOOD LOSS Acute blood loss     Trauma Chronic blood loss...
INCREASED RED CELL DESTRUCTION (HEMOLYSIS)Inherited genetic defects Red cell membrane disorders               Hereditary s...
DECREASED RED CELL PRODUCTIONInherited genetic defects Defects leading to stem cell      Fanconi anemia, telomerase defect...
END
Dr.CSBR.Prasad, M.D.,Associate Professor of Pathology,Sri Devaraj Urs Medical College,         Kolar-563101,           Kar...
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Rbc disorders 1

  1. 1. RBC Disorders Dr.CSBR.Prasad, M.D.,
  2. 2. Clinical presentations
  3. 3. Fatigue
  4. 4. Pallor / Anemia
  5. 5. Spoon nails [Koilonychia]
  6. 6. Jaundice
  7. 7. Prolonged Neonatal jaundice
  8. 8. Hepatosplenomegaly
  9. 9. Hepatosplenomegaly
  10. 10. Delayed mile stones +organomegaly
  11. 11. PigmentedGall stones in young Persons
  12. 12. Ruddy facies ofpolycytehmia
  13. 13. Some terms• Anisocytosis• Poikilocytosis – Schistocytes – Stomatocytes – Elliptocytes – Sickle cells – Spherocytes• Polychromasia• Normocyte• Microcyte• Macrocyte• Rouleaux formation• RBC Agglutinates
  14. 14. Normocyte
  15. 15. Microcyte
  16. 16. Macrocyte
  17. 17. Spherocyte
  18. 18. Anisopoikilocytosis
  19. 19. Polychromatic cells
  20. 20. Hypochromia
  21. 21. RBC agglutinates
  22. 22. Rouleaux formation
  23. 23. The nucleated RBC in the center contains basophilic stippling of the cytoplasm. This suggests atoxic injury to the bone marrow. Such stippling may also appear with severe megaloblasticanemia.
  24. 24. Sickle cell anemia
  25. 25. RBC Indices• HGB• RBC count• HCT• MCV• MCH• MCHC• RDW
  26. 26. Here is data from a CBC in a person with iron deficiency anemia. Note the lowhemoglobin (HGB). Microcytosis is indicated by the low MCV (mean corpuscularvolume). Hypochromia correlates here with the low MCH (mean corpuscularhemoglobin).
  27. 27. The CBC here shows a markedly increased MCV, typical for megaloblastic anemia. TheMCV can be mildly increased in persons recovering from blood loss or hemolyticanemia, because the newly released RBCs, the reticulocytes, are increased in size overnormal RBCs, which decrease in size slightly with aging.
  28. 28. This CBC demonstrates findings suggestive of spherocytosis, a condition in which theRBCs are small and round (rather than the normal biconcave appearance) withincreased hemoglobin content. This is indicated here by the increase MCHC (meancorpuscular hemoglobin concentration). There is a rare condition known as hereditaryspherocytosis. Also, RBCs in the condition of autoimmune hemolytic anemia can alsoappear similarly.
  29. 29. Anemias
  30. 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. 31. Anemia Definition:Decrease in hemoglobin concentrationbelow the normal value for the age, sex and for the given individual
  32. 32. Classification of anemiasThere are many classifications of anemia• Based on underlying mechanisms• Morphologic characteristics
  33. 33. Anemias due to BLOOD LOSS Mechanism Specific Examples BLOOD LOSS Acute blood loss Trauma Chronic blood loss Gastrointestinal tract lesions, gynecologic disturbances
  34. 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 synthetasedeficiencies 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 hemoglobinuriaglycoproteinsAntibody-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 choppingInfections of red cells Malaria, babesiosisToxic or chemical injury Clostridial sepsis, snake venom, lead poisoningMembrane lipid abnormalities Abetalipoproteinemia, severe hepatocellular liver diseaseSequestration Hypersplenism
  35. 35. DECREASED RED CELL PRODUCTIONInherited genetic defects Defects leading to stem cell Fanconi anemia, telomerase defectsdepletion Defects affecting erythroblast Thalassemia syndromesmaturationNutritional deficiencies Deficiencies affecting DNA B12 and folate deficienciessynthesis Deficiencies affecting hemoglobin Iron deficiency anemiasynthesisErythropoietin deficiency Renal failure, anemia of chronic diseaseImmune-mediated injury of Aplastic anemia, pure red cellprogenitors aplasiaInflammation-mediated iron Anemia of chronic diseasesequestrationPrimary hematopoietic neoplasms Acute leukemia, myelodysplasia, myeloproliferative disorders ( Chapter 13 )Space-occupying marrow lesions Metastatic neoplasms, granulomatous diseaseInfections of red cell progenitors Parvovirus B19 infectionUnknown mechanisms Endocrine disorders, hepatocellular liver disase
  36. 36. END
  37. 37. Dr.CSBR.Prasad, M.D.,Associate Professor of Pathology,Sri Devaraj Urs Medical College, Kolar-563101, Karnataka, INDIA. csbrprasad@reiffmail.com
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