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Anemia Overview Ruozhi Xiao The Third Hospital of Sun Yat-sen University [email_address]
Erythrocytes parameters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Survival and Production of RBC ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
ERYTHROPOIESIS In developing from the stem cell, the RBC has to undergo the most changes, which can be categorized into several morphological/stainable stages  Proerythroblast RBC * -blast is the common suffix for an immature form of a cell Early erythroblast Intermediate erythroblast Late erythroblast Reticulocyte … … … … Stem cell
Hematocrits Normal, Hemorrhage, IDA, Leukemia, Hemolysis, B12, P Vera Plasma White cells Red cells
Definitinon ,[object Object],[object Object],[object Object]
The normal range for Hb and RBC   ,[object Object],[object Object],[object Object],[object Object]
Anemia classification ,[object Object],[object Object]
Anemia morphological classification ,[object Object],[object Object],[object Object]
morphological classification Type  MCV   fl  MCH  pg   MCHC %   Macrocytic anemia  > 100  > 32  32-35 Normocytic  anemia  80-100  27-32  32-35 Microcytic anemia   < 80  < 27  < 32
Normal Red Blood Cells - Peripheral Blood Smear
Normal Red Blood Cells
 
Microcytic anemia
Thalassemia ,[object Object],[object Object],[object Object],[object Object]
b-Thalassemia
 
  Macrocytic anemia
General mechanisms of anemia ,[object Object],[object Object],[object Object]
ANEMIA Causes - Cytoplasmic Protein Production ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The third hospital of Sun yat-sen university  :Leukemia : trauma,surgery : cancer and ulcer,menstrual periods :Renal disease :  Malaria :Lead poisoning : SLE ,[object Object]
Bone Marrow Disorders ,[object Object],[object Object],[object Object]
Aplastic Anemia Blood Bone Marrow Biopsy
Bone Marrow (BM) Biopsy Normal Aplastic
Definitions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Aplastic Anemia: Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acquired Aplastic Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Myelodysplastic Syndromes (MDS) ,[object Object],[object Object],[object Object],[object Object]
Anemia  Check MCV MCV < 80 Microcytic anemia MCV 80 - 100 Normocytic anemia MCV > 100 Macrocytic anemia Defective synthesis of: Heme iron deficiency anemia anemia of chronic disease sideroblastic anemia lead poisoning Globin chains thalassemias HbE Fe
Clinical features ,[object Object],[object Object],[object Object]
Diagnosis of Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis of Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis of Anemia ,[object Object],[object Object],[object Object],[object Object]
Diagnosis of Anemia ,[object Object],[object Object]
Common treatment to All “Anemias” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IRON DEFICIENCY ANEMIA
Terms ,[object Object],[object Object],[object Object]
CASE 1 ,[object Object]
Case 1 – Question 1 ,[object Object]
Case 1 - Question 1 Discussion ,[object Object],[object Object],[object Object],[object Object],[object Object]
CASE 1  -  Question 2 ,[object Object]
Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object]
IRON DEFICIENCY ANEMIA Prevalence
IRON ,[object Object],[object Object],[object Object]
IRON DEFICIENCY ANEMIA ,[object Object],[object Object],[object Object],[object Object],[object Object]
Iron Metabolism ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Iron Absorption ,[object Object],[object Object],[object Object],[object Object]
Iron Absorption ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IRON Body Compartments - 75 kg man 3 mg Absorption < 1 mg/day Excretion < 1 mg/day Stores 1000mg Tissue 500 mg Red Cells 2300 mg
Iron deficiency anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
IRON DEFICIENCY ANEMIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IRON DEFICENCY - STAGES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IRON DEFICIENCY ANEMIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CHARACTERISTICS SYMPTOMS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
KOILONYCHIA   ,[object Object], 
Smooth tongue
IRON DEFICIENCY ANEMIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BLOOD ROUTINE
BLOOD AND  BONE MARROW SMEAR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anemia: Lab Evaluation ,[object Object],[object Object]
IDA blood smear
IDA bone marrow
Normal store iron(blue)
IDA
Reticulocytes up
Using special stains such as methylene blue  or brilliant cresyl blue, reticulocytes stain with  dark blue granules whereas mature  erythrocytes evenly stain pale blue.
Management ,[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IRON DEFICIENCY ANEMIA CURE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IRON DEFICIENCY ANEMIA CURE ,[object Object],[object Object],[object Object],[object Object]
Remember: Iron deficiency anemia is a manifestation of an underlying process. Look for and treat the cause of the iron deficiency.
Look for the cause ,[object Object]
Iron Deficiency anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The End

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