Anemia

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Anemia

  1. 1. Anemia
  2. 2. Definition:  According to world health organization criteria, anemia is defined as blood hemoglobin (Hb) concentration <130g/l (13g/dl) or hematocrit (Hct) <39% in adult males; Hb < 120 g/dl or Hct <37% in adult females.
  3. 3. Signs and symptoms:  Depends on: ◦ Level of anemia ◦ Time course of developing:  Acute  chronic
  4. 4. Physiologic approach  Inadequate production ◦ Hypoproliferative ◦ Ineffective  Destruction  Hemolysis  Loss
  5. 5. Retic index:  RI is a measure of RBC production.  Reticulocyte count is corrected for Hct level and for early release of marrow reticulocytes into the circulation.  RI= % reticulocytes*(pt Hct/45)* (1/shift correction factor)
  6. 6. Hypoproliferatives:  Marrow damage ◦ Infiltration/ fibrosis ◦ Aplasia  Early iron deficiency  Low stimulation  Inflamation  Metabolic defect  Renal disease
  7. 7. Iron deficiency:
  8. 8. Diagnosis of hypoproliferative anemia
  9. 9. Maturation disorders:  Microcytic: ◦ Defective cytoplasmic synthesis tests Iron deficiency inflammation thalassemia Sidroblastic anemia Smear Micro/hypo Normal micro/hypo Micro/hypo with targeting variable SI <30 <50 Normal to high Normal to high TIBC >360 <300 normal normal Perecent saturation <10 10-20 30-80 30-80 Ferritin <15 30-200 30-300 50-300 electrophor esis Normal Normal Abnormal b thalasemia Normal
  10. 10. Maturation disorders:  Macrocytic  Defects in DNA synthesis: ◦ Nutritional ◦ Toxic(methotraxate for example) ◦ Intrinsic marrow maturation defects (refractory anemia, myodysplasia)
  11. 11. hemolysis

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