There are three main types of anemia: hemorrhagic anemia caused by blood loss, hemolytic anemia due to the destruction of red blood cells, and dyshaemopoiesis where the bone marrow is unable to produce new red blood cells. Anemia can be classified morphologically based on the size and hemoglobin content of red blood cells. Pernicious anemia is caused by a lack of intrinsic factor resulting in vitamin B12 deficiency. Sickle cell anemia is an inherited condition where hemoglobin is abnormal, causing red blood cells to take on a sickle shape. Megaloblastic anemia can be caused by folic acid or B12 deficiency, preventing normal red blood cell maturation. Iron

1. ANAEMIA

2. ANAEMIA
Anaemia is a clinical condition due to reduction
in number of RBCs or less Hb estimation can
produce anaemia. If the RBC count will decrease
upto 1 million/µl of blood or the Hb estimation will
be 8 gm% that will produce anaemia.

3. ETIOLOGICALCLASSIFICATIO
NIt is based upon the cause of disease:
• Haemorrhagic Anaemia:
Any haemorrhage or blood loss can produce by
acute reason or chronic reason for eg: In any
accidental case of peptic ulcer there will be
chronic anaemia due to blood loss.

4. Haemorrhagic Anaemia

5. • Haemolytic Anaemia
Anaemia due to excessive destruction of the
RBCs can produce anaemia. It may be exposure
of some drugs or rays or gas poisoning

6. Haemolytic Anaemia

7. Haemolytic Anaemia

8. • Dyshaemopoiesis:
It is abnormal haemopoiesis resulting aplastic
anaemia. It is due to X rays, gamma rays, and
some drugs which destroy the activity of bone
marrow, So there is haemopoiesis dysfunctioning
or destruction.

9. MORPHOLOGIC
CLASSIFICATIONIt is based on size of the RBCs and its haemoglobin concentration
• Pernicious Anaemia: (Addison’s Disease)
It means destructive or injurious anaemia
Cause: This is due to lack of intrinsic factors and failure of
absorption of vitamin B12
Characteristic Features: Anaemia produce hypoxia which results
stimulation of erythropoiesis in bone marrow with maturation
arrest (unmatured RBCs). Therefore, bone marrow becomes
hyperplastic, (when bone marrow does over activity). The over
activity of the bone marrow is called megaloblastic hyperplasia,
more number of immature cells

10. • Changes of blood cells:
i. Count decreases less than 12gm/dl
ii. Haemoglobin content decreases less than 12gm/dl
iii. The diameter increases upto 8.2 µm.
iv. MCHC is normal but MCV and MCH increases.
v. In peripheral smear, RBC shows nucleated, WBC and platelets both decreases.
• Changes in GIT (Gastrointestinal Tract)
i. Deficiency of intrinsic factors
ii. Destruction of Gastric mucosa.
iii. Soreness and inflammation of tongue , diarrhoea.
• Changes in Nervous system
In advance cases, demyelination of white fibre of the spinal cord which affect
the dorsal column and lateral column which produce degeneration of the spinal
cord. This is associated with tingling and numbness in hands and feet. It
produces motor and psychological and disturbances.

11. Pernicious Anaemia

12. • Sickle cell anaemia:
It is Hbs which is inherited as Mendelian dominant. Here, each ß
peptide chain of Hb position6,1 glutamic acid is replaced by valine,
therefore when Hb1 is reduced in low oxygen tension in low ph at tissue
level, It becomes much less soluble than HbA. As a result ,
Haemoglobin precipitate in a crystal form within RBC
• RBC Changes
i. It damages the cell membrane producing increased fragility of the
RBCs
ii. Crystals are elongated and RBCs becomes hook shaped or
produced sickle shaped. So if blood flow decreases to the tissues
due to increased viscosity of blood (BP increases)
iii. Sickle shaped anaemia, due to fragile RBCs and more viscosity of
the blood produces severe anaemia with secondary infections

13. Sickle cell anaemia

14. • Megaloblastic Anaemia/ Folic Acid Deficiency
Anaemia
Folic Acid deficiency produces Megaloblastic
Anaemia with Vitamin B12 deficiency
i. Less deficiency and poor absorption in GIT
ii. Increase demands during pregnancy
iii. Anti cancer drugs or anti H foliate drugs

15. Megaloblastic Anaemia/ Folic Acid Deficiency Anaemia

16. Megaloblastic Anaemia/ Folic Acid Deficiency Anaemia

17. • Iron deficiency Anaemia
Due to deficiency of iron
Causes:
i. Less dietary intake and poor absorption
ii. Due to haemorrhage or bleeding maybe acute
and chronic
iii. Defective utilisation due to poor absorption in
stomach and duodenum

18. • Characteristics
i. RBC is hypermic and microcytic
ii. MCV, MVH and MCHC decreases
iii. Bone Marrow is normoblastic hyperplasia
iv. WBCs and platelets are in normal in count
v. Nails are dry, soft, spoon shaped and tongue is
angry red in colour
vi. Serum billurubin less than 0.4 mg/dl serum iron
decreases but total iron binding capacity increases
vii. In CVS breathlessness repeated chest infection ,
headache, loss of concentration, irritability occurs in
CNS

19. Iron deficiency Anaemia

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