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Anemia
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- 2. DEFINITION A condition inwhich the haemoglobin content of blood is lower than normal as result of a deficiency of one or more essential nutrients, regardless of the cause of such deficiency WHO
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- 4. WHO GRADING OFANAEMIA • Grade 1 (Mild Anemia): 10 g/dl • Grade 2 (Moderate Anemia): 7-10 g/dl • Grade 3 (Severe Anemia): below 7 g/dl
- 5. CLASSIFICATION Anaemia On the basis of cause Decreased RBC production Bloodloss Increased RBC destruction On the basis of morphology Normocytic Microcytic Macrocytic
- 6. ON THE BASISOF CAUSE Decreaesd RBC Production • Decreased Hemoglobin Synthesis • Iron deficiency • Thalassemias (decreased globin synthesis) • Sideroblastic anemia (decreased porphyrin) • Defective DNA Synthesis • Cobalamin (vitamin B12) deficiency • Folic acid deficiency • Decreased Number of RBC Precursors • Aplastic anemia and inherited disorders (e.g., Fanconi syndrome)
- 7. • Anemia ofmyeloproliferative diseases (e.g., leukemia) and myelodysplasia • Chronic diseases or disorders • Medications and chemicals (e.g., chemotherapy, lead) • Radiation Blood Loss • Acute • Trauma • Blood vessel rupture • Splenic sequestration crisis
- 8. Chronic • Gastritis • Menstrualflow • Hemorrhoids 3. Increased BBC Destruction (Hemolytic Anemia) • Hereditary (Intrinsic) • Abnormal hemoglobin(sickle cell disease ) • Enzyme deficiency (G6PD) • Membrane abnormalities (paroxysmal nocturnal hemoglobinuria, hereditary spherocytosis) • Acquired (Extrinsic)
- 9. Contd… • Macroangiopathic: physicaltrauma(prosthetic heart valves, extracorporeal circulation) • Microangiopathic: disseminated intravascular coagulopathy(DIC), thrombotic thrombocytopenic purpura (TTP) • Antibodies (isoimmune and autoimmune) • Infectious agents (e.g.: malaria) and toxins
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- 13. THALASSEMIA Due to etiologicfactor Disturbance of ratio between the alpha & beta globin chain synthesis Then decrease production of one or more globin chains
- 14. THALASSEMIA Formation of abnormalHb structure Ineffective erythropoiesis Excessive RBC destruction Iron overload
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- 16. APLASTIC ANAEMIA • Congenital(Chromosomalabnormalities) - Fanconi syndrome - Dyskeratosis - Amegakaryotic thrombocytopenia - Schwachman- Diamond syndrome
- 17. Contd… • Acquired - Idiopathicor autoimmune - Chemical agents & toxins - Drugs - Radiation - Viral & bacterial infection
- 18. CLINICAL MANIFESTATIONS OF BLOODLOSS % ML MANIFESTATIONS 10 500 None or rare vasovagal syncope 20 1000 No detectable signs or symptoms at rest. Tachycardia with exercise and slight postural hypotension. 30 1500 Normal supine blood pressure and pulse at rest. Postural hypotension and tachycardia with exercise. 40 2000 Blood pressure, central venous pressure and cardiac output below normal at rest; air hunger; rapid thready pulse and cold, clammy skin. 50 2500 Shock, lactic acidosis, and potential death.
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- 21. COMPLICATIONS • Spleen failureleads to autosplenectomy • Pneumonia • Acute chest syndrome • Pulmonary infarction • Heart failure • Retinal vessel obstruction
- 22. CONTD… • Renal failure •Pulmonary embolism • Chronic leg ulcers • Priapism