2. ANAEMIA
• Anemia is defined as the reduced Hb con. in
blood below the lower limit of the normal
range for the age and sex of the individual
• Normal Hb values
Males :- 14- 16gm/dl
Females :- 12-14 gm/dl
• New born infants :- 15-17 gm /dl
• In western Males< 13.2 gm /dl
• Females < 11.7 gm /dl taken as anemia
3.
4. • Anemia is not a diseases but it is the
expression of underlying disease and from
the treatment point of view , it is necessary
to identify the cause of anemia
5. WHO criteria
• Adult M <13gm/dl
• Adult F< 12gm/dl
• Infant & children's up to 12 yrs <11gm/dl
• Pregnant women <11gm/dl
• Other parameters
• RBC count, PCV, & absolute values( MCV,
MCH, MCHC) are the other alternative
parameters
8. Morphological classification
• Based on the red cell size, Hb content , red
cell indices
• Classified in to 3 types
Microcytic hypochromic
Normocytic normochromic
Macrocytic normochromic
9.
10. Microcytic hypochromic :-
Many RBCs smaller than normal(MCV<80fL)
TheRBCs are usually hypochromic(MCH<27pg)
Increased zoneof centralpallor
Cells are various in shape &size
MCV,MCH,MCHC are reduced
o Eg:- iron deficiency anemia(IDA)
o And in certain non iron deficicient anaemia
(Sideroblastic anemia),
o Thalassaemia,
o Anaemia of chronic disorder(ACD)
14. Normocytic anaemia can be presented with
elevation of reticulocyte count or a reduction of
reticulocyte count.
Elevated
reticulocytecount
• Blood loss
anaemia
• Haemolytic
anaemia
Normal or low
reticulocyte count
• Bone marrow
disorders(Aplasti
c anaemia)
• Chronicdisease
• Kidney disease
14JTV/KMC/Patho
15. Macrocytic normochromic
Theaveragesizeof RBCsare larger
than normal(>100fL) ie MCV is raised.
{MCHCis normal or high}
Eg:- megaloblastic anaemia( vit B12 &
folic acid deficiency)
2 types of macrocytes
Oval macrocytes are seen in
megaloblastic anaemia
Round macrocytes are seen in liver
disease.
17. ETIOLOGICAL CLASSIFICATION
• A) ANAEMIA DUE TO BLOOD LOSS
2 TYPES
1. A/C blood loss
Eg :Accidents
Surgery
2. Anaemia of chronic blood loss
Eg: Peptic ulcer
Parasitic infection
GIT bleeding
18. B.ANAEMIA DUE TO IMPAIRED RED
CELL FORMATION
a)Defect in Hematopoietic stem cell
proliferation and differentiation
- Aplastic anaemia
- Pure red cell aplasia
• b)Cytoplasmic metabolic defect
-Deficient haem synthesis(IDA)
-Deficient globin synthesis(Thalassaemia)
19. c)Nuclear maturation defect
-Vit B12 & Folic acid def(megaloblastic)
d)Nutritional deficiency
IDA ,MBA
e)Anaemia of chronic disorders
- Anemia due to inflammation/ infections
- Anaemia in renal disease
- Anaemia in liver disease
21. C) Anaemia due to increased red
destruction/ Haemolytic anaemia
1.Intrinsic red cell abnormalities(Intracorpuscular)
2.Extrinsic red cell abnormalities (Extracorpuscular)
(acquired haemolytic anaemia)
Intrinsic
Hereditary Acquired
PNH
Infections
23. KINETIC CLASSIFICATION
• Based On Reticulocyte Production Index
• RPI = Reticulocyte count x HCT
Reticulocyte maturation time x0.4
Hypocellular RPI < 2
Hypercellular RPI > 3
24.
25. Pathophysiology of anaemia
• Subnormal level of Hb causes lowered O2
carrying of blood
• This initiates compensatory physiologic
adaptations
Increased release of O2 from blood
Increased blood flow to tissue
Maintains of blood volume
• Redistribution of blood flow to maintain
cerebral blood supply.
26. Clinical Features Of Anaemia
1.Speed of onset of anaemia
• Rapidly progressive anaemia cause more
symptoms than that of slow on set anaemia,
less time for physiologic adaptation
2.Severity of anaemia
• No signs & symptoms in some anaemia
Mild 9.1 -10.5 g/dl
Moderate -6-9 g/dl
Severe <6 g/dl of Hb
27. 3.Age of the patient
Young patient due to good cardiovascular
compensation tolerate Anaemia
Elderly people develop cardiac & cerebral
symptoms
4.Spurious anaemia
Red cell concentration decreases due to
hemodilution as in 3rd trimester of pregnancy
36. HISTORY
• Onset of symptoms –A/C or insidious
• History of drug intake,exposure to chemicals
• Family history of similar d/s
• Occupation of pt
• Glossitis,stomatitis
• Haematuria, tarry stools
• No. of pregnancies
• H/o of jaundice
• Pain in legs