Anaemia classification final last new


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Anaemia classification final last new

  1. 1. Classification of Anaemia By, Manuji Weerasinghe Chathuran Perera Ridma Perera Buddima Perera Praneeth Madusanka Perera
  2. 2. What is Anaemia? Definition of Anaemia Anemia is reduced Haemoglobin concentration in blood more than the amount appropriate for that age, sex, race and physiological status. Normal ranges of Hb Men: Hb 13.5 -17.5 g/dL Women: Hb 11.5-16 g/dL Infants : Hb 14 – 20 g/dL
  3. 3. Blood loss On the basis of cause Inadequate production of normal blood cells Excessive destruction of blood cells Classification of anaemia Normocytic On the basis of morphology of RBC Macrocytic Microcytic
  4. 4. Classification according to Morphology of RBC • The average size of RBC (MCV) provides a convenient and informative framework to categorize the various types of anaemia
  5. 5. Normocytic Normochromic Anaemia • The primary cause - reduction of number of RBCs. Eg: Endocrine disorders (hypopituitarism, hypothyroidism and hypoadrenalism) Haematological disorders(aplastic anaemia ,haemolytic anaemias) Acute blood loss Anaemia of chronic diseases
  6. 6. Normal Put a normal BP Normocytic
  7. 7. Normocytic anaemia can be presented with elevation of reticulocyte count or a reduction of reticulocyte count. Elivated reticulocyte count • Blood loss anaemia • Haemolytic anaemia Normal or low reticulocyte count • Bone marrow disorders(Aplastic anaemia) • Chronic disease • Kidney disease
  8. 8. Microcytic Anaemia Many RBCs smaller than normal (MCV<80fL) The RBCs are usually hypochromic (MCH<27pg) Increased zone of central pallor Cells are various in shape & size
  9. 9. Normal Put a normal BP Try to find a better picture of microcytic BP Microcytic
  10. 10. Microcytic Anaemia Iron deficiency anaemia Due to other reasons Serum Ferritin level > 50µg/L Serum Ferritin level > 50µg/L Thalassaemia trait (α or β) due to inadequate iron for Hb synthesis) Anaemia of chronic disease Sideroblastic anaemia(Inherited) Lead poisoning
  11. 11. Sideroblastic anaemia Bone Marrow Picture
  12. 12. Macrocytic Anaemia • The average size of RBCs are larger than normal(>100fL) • {MCHC is normal or high} • Can be divided in to 2 types Megaloblastic anaemia Non megaloblastic anaemia
  13. 13. Normal Macrocytic
  14. 14. Macrocytic Anaemia    A. MEGALOBLASTIC ANAEMIA Vitamin B12 deficiency Folate deficiency Abnormal metabolism of folate and vit B12      B. Non megaloblastic anaemia Liver disease Alcoholism Post splenoctomy Neonatal macrocytosis Stress erythropoiesis
  15. 15. Impaired production (hypoproliferative) Anaemia Blood loss (on the basis of cause) (Haemorrhagic) Increase destruction (Haemolytic)
  16. 16. Reduced RBC Production • • • • • • Stem cell defects Nutritional deficiency Erythropoietin deficiency Hormone deficiency Inhibitory effects of Cytokines Unsuitable microenvironment - Aplastic anaemia Fe deficiency anaemia Chronic renal faliure Hypothyroidism Chronic diseases Secondary deposits
  17. 17. Increased Loss (Anaemia due to haemorrhage) • Acute blood loss • Chronic blood loss
  18. 18. Haemolytic Anaemia Inherited Red cell membrane defects Hb abnormalities Aquired Metabolic disorders of RBC immune Non immune
  19. 19. Inherited haemolytic anaemia 1)Red cell membrane defects Eg:  Hereditary spherocytosis  Hereditary Elliptocytosis  Hereditary Stomatocytosis
  20. 20. Eliptocytosis Spherocytosis Stomatocytosis
  21. 21. Inherited haemolytic anaemia 2)Hb abnormalities Eg: Thalassaemia Sickle Cell Anaemia
  22. 22. Thalassaemia Target cells
  23. 23. Sickle Cell Anaemia
  24. 24. Inherited haemolytic anaemia 3)Metabolic disorders of RBCs Eg:  Glucose-6-phosphate Dehydrogenase deficiency  Pyruvate Kinase deficiency
  25. 25. Aquired haemolytic anaemia (Immune) Eg:  Autoantibodies  Drug induced Antibodies  Allo Antibodies
  26. 26. Aquired haemolytic anaemia (Non immune) Eg:  MAHA – Micro Angiopathic Haemolytic Anaemia(due to abnormal micro vessels)  Parasites – Malaria  Burns – Abnormal vessels
  27. 27. Malaria
  28. 28. Dr.Champa Wijewickrama