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Hematological aspects  in systemic diseases Dr.Tanyarat Jomgeow
Hematological manifestation  in systemic diseases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chronic disorders  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathogenesis of chronic disorders  Inflammatory in chronic diseases Decreased release iron from macrophage Increased release cytokines, IL-6, IL-1, TNF ,[object Object],[object Object]
Malignant diseases  Hematological manifestation  RBC - Anemia chronic disorders, blood loss,  iron deficiency, folate deficiency, hemolysis marrow infiltration, marrow suppression  from chemotherapy or radiotherapy - Leukoerythroblasic blood film (NRBC and  immature granulocyte ) -  Polycythemia => tumor of renal, hepatic,  cerebellar, uterine
Malignant diseases  Hematological manifestation  WBC - Leukemoid reaction wide spread of tumor necrosis and  inflammation Platelet and blood coagulation - Thrombocytosis or thrombocytopenia -  Metastasis tumor => DIC, hemostasis failure
Autoimmune diseases and  other connective tissue disorders  Hematological manifestation  RBC - Anemia , RBC agglutination, rouleaux formation autoimmune hemolytic anemia chronic disorders iron deficiency by GI bleeding associated  with salicylates, anti-inflammatory drugs,  corticosteroid WBC  - Leukocytosis or leukopenia
Hematological manifestation  Platelet - autoimmune thrombocytopenia Coagulation - lupus anticoagulant interfere blood coagulation Autoimmune diseases and  other connective tissue disorders  *LE, ANF/ANA positive, ESR raised
Renal diseases Hematological manifestation  RBC -  Anemia Chronic diseases => chronic renal failure Uremia => inhibit erythroid proliferation   => burr cells Dialysis => blood loss, aluminium excess Erythropoietin  HUS (hemolytic uremic syndrome) - Microangiopathic hemolytic anemia,  fragmented RBC, hematuria - thrombocytopenia
Liver diseases Hematological manifestation  RBC -  Anemia *macrocytic anemia with target cells  (increased of choresterol in membrane) *hemolytic anemia in chronic immune  hepatitis * Viral hepatitis associated with aplastic    anemia Coagulation Deficiency of Vit-K dependent coagulation factor (factor II, VII, IX, X)
Infection Hematological manifestation  Bacteria Acute bacterial infection - neytrophil leukocytosis, toxic granulation - Dohle bodies, shift to the left of granulocyte Septicemia - severe hemolytic anemia - Leukemoid reaction  - DIC
Infection Hematological manifestation  Viral infection - mildly anemia (acute viral infection) - Infectious mononucleosis , atypical lymphocyte - Some patients develop PNH, TTP-HUS - Aplastic anemia may occur in viral hepatitis, EBV,  CMV   - Thrombocytopenia and platelet clumping
Infection Hematological manifestation  Malaria - Hemolysis  - DIC - Thrombocytopenia - Chronic disorder => anemia - Splenomegaly

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Hemato in systemic diseases

  • 1. Hematological aspects in systemic diseases Dr.Tanyarat Jomgeow
  • 2.
  • 3.
  • 4.
  • 5. Malignant diseases Hematological manifestation RBC - Anemia chronic disorders, blood loss, iron deficiency, folate deficiency, hemolysis marrow infiltration, marrow suppression from chemotherapy or radiotherapy - Leukoerythroblasic blood film (NRBC and immature granulocyte ) - Polycythemia => tumor of renal, hepatic, cerebellar, uterine
  • 6. Malignant diseases Hematological manifestation WBC - Leukemoid reaction wide spread of tumor necrosis and inflammation Platelet and blood coagulation - Thrombocytosis or thrombocytopenia - Metastasis tumor => DIC, hemostasis failure
  • 7. Autoimmune diseases and other connective tissue disorders Hematological manifestation RBC - Anemia , RBC agglutination, rouleaux formation autoimmune hemolytic anemia chronic disorders iron deficiency by GI bleeding associated with salicylates, anti-inflammatory drugs, corticosteroid WBC - Leukocytosis or leukopenia
  • 8. Hematological manifestation Platelet - autoimmune thrombocytopenia Coagulation - lupus anticoagulant interfere blood coagulation Autoimmune diseases and other connective tissue disorders *LE, ANF/ANA positive, ESR raised
  • 9. Renal diseases Hematological manifestation RBC - Anemia Chronic diseases => chronic renal failure Uremia => inhibit erythroid proliferation => burr cells Dialysis => blood loss, aluminium excess Erythropoietin HUS (hemolytic uremic syndrome) - Microangiopathic hemolytic anemia, fragmented RBC, hematuria - thrombocytopenia
  • 10. Liver diseases Hematological manifestation RBC - Anemia *macrocytic anemia with target cells (increased of choresterol in membrane) *hemolytic anemia in chronic immune hepatitis * Viral hepatitis associated with aplastic anemia Coagulation Deficiency of Vit-K dependent coagulation factor (factor II, VII, IX, X)
  • 11. Infection Hematological manifestation Bacteria Acute bacterial infection - neytrophil leukocytosis, toxic granulation - Dohle bodies, shift to the left of granulocyte Septicemia - severe hemolytic anemia - Leukemoid reaction - DIC
  • 12. Infection Hematological manifestation Viral infection - mildly anemia (acute viral infection) - Infectious mononucleosis , atypical lymphocyte - Some patients develop PNH, TTP-HUS - Aplastic anemia may occur in viral hepatitis, EBV, CMV - Thrombocytopenia and platelet clumping
  • 13. Infection Hematological manifestation Malaria - Hemolysis - DIC - Thrombocytopenia - Chronic disorder => anemia - Splenomegaly