The document discusses different types of anemias including their causes, mechanisms, and characteristics. It covers iron deficiency anemia, the most common type caused by lack of iron intake or increased loss. It also discusses megaloblastic anemias caused by vitamin B12 or folate deficiencies which result in large immature red blood cells. Thalassemia syndromes are genetic disorders that cause decreased hemoglobin production. The document also examines normocytic anemias and anemias associated with chronic diseases and infections.
This document summarizes haematological changes that can occur in systemic diseases. It discusses anaemia of chronic disorders which occurs in patients with inflammatory or malignant conditions. The anaemia is caused by decreased iron availability and erythropoietin response. It also occurs in rheumatoid arthritis, lupus, chronic kidney disease, liver disease, and hypothyroidism due to various contributing factors like blood loss, bone marrow suppression, and cytokine effects. Coagulation abnormalities can also arise in cancers, liver disease, and nephrotic syndrome.
Drugs can cause various blood dyscrasias by impairing blood cell production, increasing cell destruction, or altering cell function. Common types include anemias, aplastic anemia, hemolytic anemia, methemoglobinemia, neutropenia, and thrombocytopenia. Specific drugs are associated with each type through different mechanisms such as inhibiting folic acid or vitamin B12 absorption, inducing oxidative damage to red blood cells, or eliciting immune responses against blood cells. Treatment depends on the type of dyscrasia but may include stopping the causative drug, administering blood transfusions or growth factors, and in severe aplastic anemia, allogenic bone marrow transplantation with immunosuppression.
1. Microcytic hypochromic anaemia can be classified based on mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) levels. Defects in iron, B12/folate metabolism or haemoglobin synthesis can cause microcytic hypochromic anaemia.
2. Normocytic normochromic anaemia is seen in acute blood loss or haemolysis. Macrocytic anaemia occurs in B12/folate deficiency or liver disease.
3. Iron deficiency is one of the most common causes of microcytic hypochromic anaemia in Western countries, while thalassaemias are
1. The document discusses hematologic disorders including hematopoiesis, anemia, polycythemia, and hematologic malignancy.
2. It provides details on the pathophysiology of hematopoiesis, the definition and classification of anemia, the general approach to evaluating anemic patients, and discussions of common anemia types and their treatments.
3. Key anemia types covered include iron deficiency anemia, megaloblastic anemia due to vitamin B12 and folate deficiencies, and the morphological features seen in peripheral blood and bone marrow in these conditions.
Anemia is a below-normal concentration of hemoglobin in the blood, caused by a decreased number of red blood cells. Common symptoms include fatigue, rapid heartbeat, shortness of breath, and pale skin. Treatments for anemia include supplements like iron, cyanocobalamin (vitamin B12), folic acid, and medications like erythropoietin and darbepoetin. Iron deficiency is a common cause of anemia and can cause complications if left untreated. Sickle cell anemia can be treated with hydroxyurea or pentoxifylline to reduce painful crises.
This document summarizes haematological changes that can occur in systemic diseases. It discusses anaemia of chronic disorders which occurs in patients with inflammatory or malignant conditions. The anaemia is caused by decreased iron availability and erythropoietin response. It also occurs in rheumatoid arthritis, lupus, chronic kidney disease, liver disease, and hypothyroidism due to various contributing factors like blood loss, bone marrow suppression, and cytokine effects. Coagulation abnormalities can also arise in cancers, liver disease, and nephrotic syndrome.
Drugs can cause various blood dyscrasias by impairing blood cell production, increasing cell destruction, or altering cell function. Common types include anemias, aplastic anemia, hemolytic anemia, methemoglobinemia, neutropenia, and thrombocytopenia. Specific drugs are associated with each type through different mechanisms such as inhibiting folic acid or vitamin B12 absorption, inducing oxidative damage to red blood cells, or eliciting immune responses against blood cells. Treatment depends on the type of dyscrasia but may include stopping the causative drug, administering blood transfusions or growth factors, and in severe aplastic anemia, allogenic bone marrow transplantation with immunosuppression.
1. Microcytic hypochromic anaemia can be classified based on mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) levels. Defects in iron, B12/folate metabolism or haemoglobin synthesis can cause microcytic hypochromic anaemia.
2. Normocytic normochromic anaemia is seen in acute blood loss or haemolysis. Macrocytic anaemia occurs in B12/folate deficiency or liver disease.
3. Iron deficiency is one of the most common causes of microcytic hypochromic anaemia in Western countries, while thalassaemias are
1. The document discusses hematologic disorders including hematopoiesis, anemia, polycythemia, and hematologic malignancy.
2. It provides details on the pathophysiology of hematopoiesis, the definition and classification of anemia, the general approach to evaluating anemic patients, and discussions of common anemia types and their treatments.
3. Key anemia types covered include iron deficiency anemia, megaloblastic anemia due to vitamin B12 and folate deficiencies, and the morphological features seen in peripheral blood and bone marrow in these conditions.
Anemia is a below-normal concentration of hemoglobin in the blood, caused by a decreased number of red blood cells. Common symptoms include fatigue, rapid heartbeat, shortness of breath, and pale skin. Treatments for anemia include supplements like iron, cyanocobalamin (vitamin B12), folic acid, and medications like erythropoietin and darbepoetin. Iron deficiency is a common cause of anemia and can cause complications if left untreated. Sickle cell anemia can be treated with hydroxyurea or pentoxifylline to reduce painful crises.
Aplastic and hypoplastic anemias result from stem cell or bone marrow damage, causing low red blood cell, white blood cell, and platelet production. They can develop from drugs, toxins, radiation, viruses, or unknown causes. Symptoms include fatigue, shortness of breath, and easy bruising. Treatment focuses on blood transfusions, immunosuppressants, bone marrow transplant, and managing infections. Iron deficiency anemia, another common type, results from inadequate iron intake or absorption and causes similar symptoms. Replacement with oral or intravenous iron is the typical treatment.
This patient presents with concerning symptoms including weakness, fatigue, shortness of breath, new headache and left-sided weakness, easy bruising, bleeding gums, and fever. Her physical exam reveals a fever and petechiae. Her symptoms and exam are suggestive of thrombotic thrombocytopenic purpura (TTP), which is characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, renal insufficiency, and neurologic symptoms. A smear would likely show schistocytes, indicating microangiopathic hemolytic anemia. Immediate treatment is needed for this life-threatening condition.
The document discusses drug treatment for various blood disorders including anemias. It covers hematopoiesis and factors involved like iron, vitamin B12, folic acid, and hematopoietic growth factors. It then classifies and describes treatments for different types of anemia including iron deficiency anemia treated with oral or parental iron preparations, vitamin B12 deficiency anemia, folic acid deficiency anemia. It also discusses hematopoietic growth factors erythropoietin and colony stimulating factors used to treat chemotherapy-induced neutropenia. Overall, the document provides an overview of drug therapies for common blood disorders focused on different anemias.
This document discusses various types of anemia seen in veterinary practice and their treatment. It covers primary and secondary anemias including iron deficiency anemia, blood loss anemia, hemolytic anemia, and non-regenerative anemia. Treatment depends on the underlying cause but may include blood transfusions, iron supplementation, antimicrobials, immunosuppressants, or hormones. The document also briefly discusses polycythemia and its causes.
Anemia can be seen in the emergency department both as a primary pathological process or secondary to both medical and surgical diseases. Moreover, acute anemia can occur in children who have been otherwise healthy, who have systemic disease, or who have known hematologic disorders. Anemia may indicate a disorder with a single hematopoietic cell line (eg, red blood cells) or may be associated with changes in multiple cell lines indicative of bone marrow involvement, immunologic disease, peripheral destruction of erythrocytes, or sequestration of cells. Independent of the etiology, prompt diagnosis is predicated on understanding the classifications of anemia, the associated presenting symptoms, and the proper ordering and interpretation of laboratory studies. This article will discuss the evaluation, proper classification, differential diagnosis, and initial management of acute anemia using cases representative of those that might be seen in the pediatric emergency department.
Anemia is a condition where the hemoglobin level or red blood cell count is lower than normal. It can be caused by blood loss, decreased red blood cell production, or increased red blood cell destruction. Globally, anemia affects over 1.6 billion people. Common symptoms include fatigue, weakness, and pale skin. Diagnosis involves blood tests to measure hemoglobin, red blood cell count, and other indicators. Treatment depends on the underlying cause but may involve iron supplementation, vitamin B12/folate, blood transfusions, or treating the primary disease.
Vitamin B12 deficiency, also known as pernicious anemia, is an autoimmune disorder where antibodies block intrinsic factor and prevent vitamin B12 absorption from the stomach, leading to megaloblastic anemia. It presents with weakness, sore tongue, and neurological or gastrointestinal issues. Laboratory findings include macrocytic anemia, elevated MCV, hypersegmented neutrophils, and low serum B12 levels. The gold standard test is gastric biopsy showing parietal cell atrophy. Treatment is lifelong vitamin B12 supplementation by injection or oral administration.
This document defines anemia and discusses its etiology, pathophysiology, classification, diagnostic tests, and treatment, specifically focusing on iron deficiency anemia. It states that anemia is a decrease in red blood cells or hemoglobin, and is the most common hematologic disorder. The main causes of anemia are blood loss, deficient red blood cell production, and increased red blood cell destruction. Iron deficiency anemia, one of the most prevalent nutritional deficiencies worldwide, occurs due to an imbalance between iron needs and supply.
The document discusses different types and causes of anemia. It classifies anemia into etiologic categories including impaired red blood cell production, excessive destruction of RBCs, and blood loss. It further describes morphologic classifications such as macrocytic, microcytic hypochromic, and normocytic normochromic anemia. Specific causes are provided for each category including deficiencies, diseases, and genetic disorders. Hemolytic anemia is discussed in more detail including hereditary and acquired causes. Laboratory findings associated with different types of anemia are also summarized.
Hypochromic anemia is a type of anemia where red blood cells appear paler than normal. There are two main classifications - iron deficiency anemia and non-iron deficiency anemia which includes conditions like sideroblastic anemia, thalassemia, and anemia of chronic diseases. Iron deficiency anemia is caused by low iron intake, decreased absorption, blood loss, drugs, or transport defects. Clinical evaluation involves taking a thorough history and conducting a physical exam looking for pallor, nail changes, enlarged spleen or liver, and cardiovascular abnormalities. Investigations help determine the severity through tests like hemoglobin, ferritin, and peripheral smear examination. Treatment depends on the underlying cause but commonly involves oral or
causes of macrocytic anemia pathopysiology, sign and symptoms and the difference between macrocytic anemia megaloblastIc anemia. causes of hypersegmented neutrophils and its association between them. investigation and medical management plus pictures illustration.
This document provides an overview of blood dyscrasias (disorders of blood cells). It begins with an introduction to dyscrasia as a concept from ancient Greek medicine meaning "bad mixture." The document then discusses the history of dyscrasias and provides classifications of blood dyscrasias including disorders of red blood cells, white blood cells, hemoglobin, hemostatic mechanisms, and more. Several specific red blood cell disorders are described in detail, including iron deficiency anemia, vitamin B12 deficiency anemia, folic acid deficiency anemia, aplastic anemia, polycythemia, and hereditary spherocytosis. Management and dental considerations are provided for many of these conditions.
This document discusses microcytic hypochromic anemias and the laboratory approach used to diagnose them. It defines anemia and outlines the grading system used by the WHO. It then describes the clinical findings, types, and laboratory tests involved in evaluating microcytic hypochromic anemias, focusing on iron deficiency anemia and anemia of chronic disease. The key laboratory findings and bone marrow features of each condition are presented. Case studies are also included to demonstrate how the laboratory results can help arrive at a diagnosis.
1. Anaemia is a major health problem in farm and pet animals that can be caused by management issues. It affects red blood cell count, haemoglobin, and hematocrit levels, reducing oxygen delivery.
2. There are different types of anaemia classified by strength of erythropoiesis, cell volume/hemoglobin levels, etiology, and blood smear morphology. Common causes include parasites, viruses, bacteria, immune responses, inflammation, and nutritional deficiencies.
3. Clinical signs of anaemia include paleness, weakness, poor appetite, tachycardia, and shock in severe cases. Diagnosis involves history, clinical examination, and laboratory tests like complete blood counts and blood smears.
The document discusses various types of anemia classified based on pathophysiology and morphology. It defines anemia and provides the normal hemoglobin levels. It describes deficiencies in iron, vitamin B12, folic acid and their effects on red blood cell formation leading to anemia. Pernicious anemia results from lack of intrinsic factor causing impaired vitamin B12 absorption. Aplastic anemia is defined as pancytopenia from bone marrow failure and stem cell deficiency. The causes, clinical features and morphology of different anemias are explained.
Red blood cells normally live for around 120 days before being destroyed. Destruction can occur either inside or outside blood vessels. Defects in red blood cells themselves or outside factors can lead to hemolysis. Hemolytic anemia results when red blood cell destruction outpaces bone marrow production of new cells. Causes include immune problems, infections, enzyme deficiencies affecting red blood cell metabolism, and genetic disorders impacting hemoglobin or the red blood cell membrane. Treatment focuses on managing anemia through blood transfusions, preventing iron overload, and addressing specific underlying defects when possible.
Red cells disorders can cause anaemia through flexible biconcave disks not transporting oxygen effectively or not being able to pass through small capillaries. Anaemia is defined as low hemoglobin and can be classified as normocytic, macrocytic, or microcytic based on red blood cell indices. Common causes include iron deficiency, B12/folate deficiency, chronic disease, blood loss, and hemoglobinopathies. The red blood cell morphology and additional lab tests help determine the underlying cause of anaemia.
A condition in which the blood doesn't have enough healthy red blood cells.
Anaemia results from a lack of red blood cells or dysfunctional red blood cells in the body. This leads to reduced oxygen flow to the body's organs.
This document discusses various hematological diseases, focusing on different types of anemia. It defines anemia and describes the different types, including iron-deficiency anemia, megaloblastic anemia (which can be caused by vitamin B12 or folic acid deficiencies), aplastic anemia, and hemolytic anemia (which includes conditions like sickle cell anemia and thalassemia). It provides details on symptoms, causes, pathophysiology, and treatment for each type of anemia. Major risk factors for anemia include diet deficiencies, blood loss, illnesses, liver/spleen malfunctions, and infections.
This document discusses different types of anaemia. It covers the composition of blood and defines anaemia. It describes signs and symptoms of anaemia and discusses causes such as reduced red blood cell production, increased destruction, or blood loss. The document classifies anaemias based on mean corpuscular volume and discusses specific types in more detail including iron deficiency, anaemia of chronic disease, thalassaemia, sickle cell anaemia, and autoimmune haemolytic anaemia. Treatment options are mentioned for some types.
Aplastic and hypoplastic anemias result from stem cell or bone marrow damage, causing low red blood cell, white blood cell, and platelet production. They can develop from drugs, toxins, radiation, viruses, or unknown causes. Symptoms include fatigue, shortness of breath, and easy bruising. Treatment focuses on blood transfusions, immunosuppressants, bone marrow transplant, and managing infections. Iron deficiency anemia, another common type, results from inadequate iron intake or absorption and causes similar symptoms. Replacement with oral or intravenous iron is the typical treatment.
This patient presents with concerning symptoms including weakness, fatigue, shortness of breath, new headache and left-sided weakness, easy bruising, bleeding gums, and fever. Her physical exam reveals a fever and petechiae. Her symptoms and exam are suggestive of thrombotic thrombocytopenic purpura (TTP), which is characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, renal insufficiency, and neurologic symptoms. A smear would likely show schistocytes, indicating microangiopathic hemolytic anemia. Immediate treatment is needed for this life-threatening condition.
The document discusses drug treatment for various blood disorders including anemias. It covers hematopoiesis and factors involved like iron, vitamin B12, folic acid, and hematopoietic growth factors. It then classifies and describes treatments for different types of anemia including iron deficiency anemia treated with oral or parental iron preparations, vitamin B12 deficiency anemia, folic acid deficiency anemia. It also discusses hematopoietic growth factors erythropoietin and colony stimulating factors used to treat chemotherapy-induced neutropenia. Overall, the document provides an overview of drug therapies for common blood disorders focused on different anemias.
This document discusses various types of anemia seen in veterinary practice and their treatment. It covers primary and secondary anemias including iron deficiency anemia, blood loss anemia, hemolytic anemia, and non-regenerative anemia. Treatment depends on the underlying cause but may include blood transfusions, iron supplementation, antimicrobials, immunosuppressants, or hormones. The document also briefly discusses polycythemia and its causes.
Anemia can be seen in the emergency department both as a primary pathological process or secondary to both medical and surgical diseases. Moreover, acute anemia can occur in children who have been otherwise healthy, who have systemic disease, or who have known hematologic disorders. Anemia may indicate a disorder with a single hematopoietic cell line (eg, red blood cells) or may be associated with changes in multiple cell lines indicative of bone marrow involvement, immunologic disease, peripheral destruction of erythrocytes, or sequestration of cells. Independent of the etiology, prompt diagnosis is predicated on understanding the classifications of anemia, the associated presenting symptoms, and the proper ordering and interpretation of laboratory studies. This article will discuss the evaluation, proper classification, differential diagnosis, and initial management of acute anemia using cases representative of those that might be seen in the pediatric emergency department.
Anemia is a condition where the hemoglobin level or red blood cell count is lower than normal. It can be caused by blood loss, decreased red blood cell production, or increased red blood cell destruction. Globally, anemia affects over 1.6 billion people. Common symptoms include fatigue, weakness, and pale skin. Diagnosis involves blood tests to measure hemoglobin, red blood cell count, and other indicators. Treatment depends on the underlying cause but may involve iron supplementation, vitamin B12/folate, blood transfusions, or treating the primary disease.
Vitamin B12 deficiency, also known as pernicious anemia, is an autoimmune disorder where antibodies block intrinsic factor and prevent vitamin B12 absorption from the stomach, leading to megaloblastic anemia. It presents with weakness, sore tongue, and neurological or gastrointestinal issues. Laboratory findings include macrocytic anemia, elevated MCV, hypersegmented neutrophils, and low serum B12 levels. The gold standard test is gastric biopsy showing parietal cell atrophy. Treatment is lifelong vitamin B12 supplementation by injection or oral administration.
This document defines anemia and discusses its etiology, pathophysiology, classification, diagnostic tests, and treatment, specifically focusing on iron deficiency anemia. It states that anemia is a decrease in red blood cells or hemoglobin, and is the most common hematologic disorder. The main causes of anemia are blood loss, deficient red blood cell production, and increased red blood cell destruction. Iron deficiency anemia, one of the most prevalent nutritional deficiencies worldwide, occurs due to an imbalance between iron needs and supply.
The document discusses different types and causes of anemia. It classifies anemia into etiologic categories including impaired red blood cell production, excessive destruction of RBCs, and blood loss. It further describes morphologic classifications such as macrocytic, microcytic hypochromic, and normocytic normochromic anemia. Specific causes are provided for each category including deficiencies, diseases, and genetic disorders. Hemolytic anemia is discussed in more detail including hereditary and acquired causes. Laboratory findings associated with different types of anemia are also summarized.
Hypochromic anemia is a type of anemia where red blood cells appear paler than normal. There are two main classifications - iron deficiency anemia and non-iron deficiency anemia which includes conditions like sideroblastic anemia, thalassemia, and anemia of chronic diseases. Iron deficiency anemia is caused by low iron intake, decreased absorption, blood loss, drugs, or transport defects. Clinical evaluation involves taking a thorough history and conducting a physical exam looking for pallor, nail changes, enlarged spleen or liver, and cardiovascular abnormalities. Investigations help determine the severity through tests like hemoglobin, ferritin, and peripheral smear examination. Treatment depends on the underlying cause but commonly involves oral or
causes of macrocytic anemia pathopysiology, sign and symptoms and the difference between macrocytic anemia megaloblastIc anemia. causes of hypersegmented neutrophils and its association between them. investigation and medical management plus pictures illustration.
This document provides an overview of blood dyscrasias (disorders of blood cells). It begins with an introduction to dyscrasia as a concept from ancient Greek medicine meaning "bad mixture." The document then discusses the history of dyscrasias and provides classifications of blood dyscrasias including disorders of red blood cells, white blood cells, hemoglobin, hemostatic mechanisms, and more. Several specific red blood cell disorders are described in detail, including iron deficiency anemia, vitamin B12 deficiency anemia, folic acid deficiency anemia, aplastic anemia, polycythemia, and hereditary spherocytosis. Management and dental considerations are provided for many of these conditions.
This document discusses microcytic hypochromic anemias and the laboratory approach used to diagnose them. It defines anemia and outlines the grading system used by the WHO. It then describes the clinical findings, types, and laboratory tests involved in evaluating microcytic hypochromic anemias, focusing on iron deficiency anemia and anemia of chronic disease. The key laboratory findings and bone marrow features of each condition are presented. Case studies are also included to demonstrate how the laboratory results can help arrive at a diagnosis.
1. Anaemia is a major health problem in farm and pet animals that can be caused by management issues. It affects red blood cell count, haemoglobin, and hematocrit levels, reducing oxygen delivery.
2. There are different types of anaemia classified by strength of erythropoiesis, cell volume/hemoglobin levels, etiology, and blood smear morphology. Common causes include parasites, viruses, bacteria, immune responses, inflammation, and nutritional deficiencies.
3. Clinical signs of anaemia include paleness, weakness, poor appetite, tachycardia, and shock in severe cases. Diagnosis involves history, clinical examination, and laboratory tests like complete blood counts and blood smears.
The document discusses various types of anemia classified based on pathophysiology and morphology. It defines anemia and provides the normal hemoglobin levels. It describes deficiencies in iron, vitamin B12, folic acid and their effects on red blood cell formation leading to anemia. Pernicious anemia results from lack of intrinsic factor causing impaired vitamin B12 absorption. Aplastic anemia is defined as pancytopenia from bone marrow failure and stem cell deficiency. The causes, clinical features and morphology of different anemias are explained.
Red blood cells normally live for around 120 days before being destroyed. Destruction can occur either inside or outside blood vessels. Defects in red blood cells themselves or outside factors can lead to hemolysis. Hemolytic anemia results when red blood cell destruction outpaces bone marrow production of new cells. Causes include immune problems, infections, enzyme deficiencies affecting red blood cell metabolism, and genetic disorders impacting hemoglobin or the red blood cell membrane. Treatment focuses on managing anemia through blood transfusions, preventing iron overload, and addressing specific underlying defects when possible.
Red cells disorders can cause anaemia through flexible biconcave disks not transporting oxygen effectively or not being able to pass through small capillaries. Anaemia is defined as low hemoglobin and can be classified as normocytic, macrocytic, or microcytic based on red blood cell indices. Common causes include iron deficiency, B12/folate deficiency, chronic disease, blood loss, and hemoglobinopathies. The red blood cell morphology and additional lab tests help determine the underlying cause of anaemia.
A condition in which the blood doesn't have enough healthy red blood cells.
Anaemia results from a lack of red blood cells or dysfunctional red blood cells in the body. This leads to reduced oxygen flow to the body's organs.
This document discusses various hematological diseases, focusing on different types of anemia. It defines anemia and describes the different types, including iron-deficiency anemia, megaloblastic anemia (which can be caused by vitamin B12 or folic acid deficiencies), aplastic anemia, and hemolytic anemia (which includes conditions like sickle cell anemia and thalassemia). It provides details on symptoms, causes, pathophysiology, and treatment for each type of anemia. Major risk factors for anemia include diet deficiencies, blood loss, illnesses, liver/spleen malfunctions, and infections.
This document discusses different types of anaemia. It covers the composition of blood and defines anaemia. It describes signs and symptoms of anaemia and discusses causes such as reduced red blood cell production, increased destruction, or blood loss. The document classifies anaemias based on mean corpuscular volume and discusses specific types in more detail including iron deficiency, anaemia of chronic disease, thalassaemia, sickle cell anaemia, and autoimmune haemolytic anaemia. Treatment options are mentioned for some types.
Anemia, thalassemia and hemophilia in childrenNimmy Tomy
This document defines and discusses different types of anemia, including hemolytic anemia. It notes that anemia is a low red blood cell or hemoglobin level, reducing oxygen delivery. Causes include decreased or ineffective red blood cell production, increased red blood cell destruction (hemolytic anemia), and blood loss. Hemolytic anemia specifically refers to the premature breakdown of red blood cells, either inside or outside blood vessels. Causes can be genetic defects affecting red blood cells or acquired factors like immune system attacks or infections. Symptoms range from none in mild cases to fatigue, palpitations, and jaundice in more severe cases.
Anemia - Types, Pathophysiology, Clinical Manifestations, Etiology, TreatmentMd Altamash Ahmad
Anaemia can be defined as a reduction from normal of the quantity of haemoglobin in the blood.
It is not one disease, but a condition that results from a number of different pathologies.
The World Health Organisation defines anaemia in adults as haemoglobin levels less than 13g/dL for males and less than 12g/dL for females.
The low haemoglobin level results in a corresponding decrease in the oxygen-carrying capacity of the blood.
Anaemia is possibly one of the most common conditions in the world and results in significant morbidity and mortality, particularly in the developing world.
This document discusses anemias caused by diminished red blood cell production. It covers various inherited and acquired causes, including nutritional deficiencies, bone marrow failure disorders, infiltrative bone marrow disorders, and decreased erythropoietin production. It focuses in depth on megaloblastic anemias caused by vitamin B12 and folate deficiencies, providing details on the mechanisms, morphology, and clinical features of pernicious anemia specifically.
This document discusses various types of anemia. It defines anemia and describes how it is classified based on red blood cell size, hemoglobin content, and underlying pathophysiological mechanism. Several specific types of anemia are then discussed in more detail, including iron deficiency anemia, aplastic anemia, pure red cell aplasia, anemia of chronic disease, hereditary spherocytosis, and glucose-6-phosphate dehydrogenase deficiency. For each type, the document outlines causes, pathophysiology, clinical manifestations, laboratory/blood smear findings, and treatment.
Understanding the full blood count in 15mins - A quick lit reviewSimon Daley
This document provides an overview of the components and interpretation of a full blood count (FBC). It describes the constituents that are measured for red blood cells, white blood cells, and platelets. For red blood cells, it covers hematological parameters, causes and types of anemia, and polycythemia. It also discusses the most common causes of anemia like iron deficiency, B12 deficiency, and folate deficiency. For white blood cells, it lists the different types and what high or low counts may indicate. Finally, it briefly summarizes causes and workup for thrombocytopenia and thrombocytosis.
1. The document discusses various blood disorders that affect the red blood cells, white blood cells, platelets, and coagulation system.
2. Key red blood cell disorders discussed are anemias, hemolytic anemias like sickle cell anemia and thalassemia, and polycythemia.
3. Important white blood cell disorders mentioned are leukopenia and various forms of leukemia.
4. Coagulation disorders covered include disseminated intravascular coagulation and deficiencies of clotting factors.
Poikilocytosis diagnostic criteria and testsyaduniversity
This document discusses biochemical basis, clinical features, and laboratory findings of megaloblastic anemia (MBA). MBA is characterized by impaired DNA synthesis due to deficiencies in vitamin B12 or folic acid, which are required for thymidylate synthesis and DNA polymerization. Clinical features include anemia, jaundice, neurological abnormalities, and epithelial tissue changes. Laboratory findings show macrocytic blood cells, low red blood cell count, and increased mean corpuscular volume. The document also discusses pernicious anemia, G6PD deficiency, and investigations for diagnosing bleeding disorders.
The document discusses several types of blood disorders that can cause anemia or other issues. It describes red blood cell disorders like iron deficiency anemia, thalassemia, sickle cell anemia and glucose-6-phosphate dehydrogenase deficiency that can lead to hemolytic anemia. It also discusses anemia of chronic disease/inflammation and megaloblastic anemias caused by vitamin B12 or folate deficiencies that result in diminished red blood cell production. Malaria is summarized as a parasitic infection that can cause hemolytic anemia.
The document discusses vitamin B12 and folate deficiency, which can cause megaloblastic anemia characterized by macrocytic red blood cells and hypersegmented neutrophils. Folate and vitamin B12 are important cofactors in DNA synthesis and methylation reactions. Deficiencies can result from malnutrition, malabsorption, excessive utilization, or antifolate drugs. The document also discusses inherited and acquired causes of anemia, including disorders affecting hemoglobin synthesis, DNA repair, iron absorption, and red blood cell enzyme deficiencies impacting energy production and antioxidant defenses.
Anemia is a decrease in red blood cells or hemoglobin. It can be caused by nutritional deficiencies, infections, blood loss, or genetic disorders. Anemia is classified based on cell size and cause. Symptoms include fatigue, paleness, and shortness of breath. Diagnosis involves blood tests. Treatment depends on the underlying cause but may include iron supplements, blood transfusions, or medications. Nursing care focuses on managing symptoms, preventing complications, and health education.
This document discusses different types of anemia. It begins by introducing the three main blood cell groups - red blood cells, white blood cells, and platelets. It then focuses on red blood cells and hemoglobin, the oxygen-carrying molecule. The document defines anemia and provides reference levels for hemoglobin. It describes different types of anemia classified by mean corpuscular volume (MCV), including microcytic (low MCV), normocytic (normal MCV), and macrocytic (high MCV) anemias. Microcytic anemias discussed in more detail include iron deficiency anemia, thalassemia, and sideroblastic anemia. Macrocytic anemias are
This document discusses various types of anemia. It defines anemia as a reduction in hemoglobin levels and describes the most common causes as iron deficiency and nutritional deficiencies. Specific types discussed in detail include iron deficiency anemia, megaloblastic anemia caused by vitamin B12 and folate deficiencies, sickle cell anemia caused by an abnormal hemoglobin gene, thalassemias caused by genetic defects in hemoglobin production, and G6PD deficiency which affects the ability to prevent oxidative damage to red blood cells. The document covers epidemiology, pathophysiology, clinical manifestations, investigations, and treatments for each type.
This document provides an overview of anemia, including its classification and causes. It discusses:
1) The etiological classification of anemia into impaired red blood cell production, excessive destruction, and blood loss.
2) The morphologic classification into macrocytic, microcytic hypochromic, and normocytic normochromic anemia.
3) Causes of impaired red blood cell production such as bone marrow abnormalities and deficiencies in essential factors like iron, vitamin B12, and folate.
4) Causes of excessive red blood cell destruction including hereditary and acquired hemolytic anemias.
5) Different types of blood loss as a cause of anemia like acute
This document provides an overview of anemia, including its classification and causes. It discusses:
1) The etiological classification of anemia into impaired red blood cell production, excessive destruction, and blood loss.
2) The morphologic classification into macrocytic, microcytic hypochromic, and normocytic normochromic anemia.
3) Causes of impaired red blood cell production such as bone marrow abnormalities and deficiencies in essential factors.
4) Causes of excessive red blood cell destruction including hereditary and acquired hemolytic anemias.
5) Causes of blood loss such as acute or chronic bleeding.
The document discusses haematinics, which are agents used to treat anemia. It describes the components of the haematopoietic system and types of anemia. The major causes of anemia are blood loss, deficiencies in iron, vitamin B12, or folic acid, and conditions that suppress bone marrow. Iron is important for haemoglobin synthesis and absorption requires reduction to ferrous form. Folic acid and vitamin B12 act as cofactors in DNA synthesis and other metabolic pathways. Deficiencies can cause megaloblastic anemia. Haematinics like iron salts, folic acid, and vitamin B12 are used to treat various anaemias resulting from deficiencies or conditions affecting haematopoiesis
This document provides guidance on evaluating and treating anemia in children. It begins by defining anemia and outlining the key steps in the evaluation: (1) determining if the patient is anemic, (2) assessing severity, and (3) identifying the cause and type. Common causes discussed include nutritional deficiencies, bone marrow disorders, hemolytic anemias, and blood loss. A thorough physical exam and screening lab tests can help establish the diagnosis. The document then covers specific aspects of the history, exam findings, etiologies, and initial lab tests that are useful in evaluating the anemic child.
Quality control & quality assurance presentationTasmiaZeb1
This document discusses quality control and quality assurance in laboratory testing. Quality control refers to measures taken during each test run to ensure the test is working properly. Quality assurance is the overall program that ensures correct results are reported. Quality control focuses on internal processes and inputs, while quality assurance is concerned with the entire testing process from pre-analytical to post-analytical steps to deliver the right result to the right person. Quality assurance includes both internal and external measures across three phases: pre-analytical, analytical, and post-analytical.
Three common methods for estimating haemoglobin concentration are described: cyanmethaemoglobin method, alkaline haematin method, and acid haematin method. The document focuses on the cyanmethaemoglobin method. This method involves converting haemoglobin to cyanmethaemoglobin using Drabkin's solution, then measuring absorbance at 540nm and comparing to a standard. Calibration curves are prepared from standard cyanmethaemoglobin solutions. The acid haematin method uses hydrochloric acid to convert haemoglobin and compares the solution in a haemoglobinometer to a reference. Normal haemoglobin values in adults and infants are provided.
This document discusses the technique of haemocytometry, which is used to count the total number of cells in blood or other body fluids. It can be done using a haemocytometer or electronic cell counter. The purpose is to determine normal or abnormal cell counts in pathological conditions and to support clinical diagnoses and monitor treatment responses. The principle involves diluting the blood sample and counting the cells in a haemocytometer under a microscope. Proper use and interpretation of haemocytometry provides information about various blood cell types like white blood cells, red blood cells, platelets, and eosinophils.
Blood collection and preservation is the process of obtaining blood samples from patients and ensuring the blood remains suitable for testing. Proper collection techniques and timely transport to the laboratory are important to prevent clotting and hemolysis. Careful handling and storage of blood samples is necessary to maintain the integrity of the blood components for accurate diagnostic analysis.
This document discusses the calculation of red blood cell indices, including mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). These indices are calculated using measurements of total red blood cell count, packed cell volume, and hemoglobin concentration. Formulas for calculating each index are provided, along with normal reference ranges and descriptions of how the indices are affected in different types of anemias. The document notes that MCH is more reliably calculated using automated counters while MCHC can be reliably calculated manually.
Haemostasis involves three components that work together to stop bleeding after an injury. The extravascular component involves pressure from accumulated blood in tissues around blood vessels. The vascular component involves constriction of blood vessels. The intravascular component involves platelets, coagulation factors, anticoagulants, and fibrinolytic factors that form a thrombus (blood clot) at the site of injury through a balance of pro-coagulant and anticoagulant processes. Disruptions to this balance can result in bleeding disorders or hypercoagulability.
The document discusses different types of leukaemias. It describes how leukaemias can be divided into acute and chronic forms based on the clinical course of the disease and maturation state of malignant cells. Acute leukaemias are characterized by a rapid onset and presence of over 20% blast cells in bone marrow. Acute leukaemias are further classified into acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL). Chronic leukaemias have a chronic disease course and mature malignant cells, including chronic myeloid leukaemia, chronic lymphocytic leukaemia, and others.
The document provides an overview of red blood cell morphology, describing normal red blood cell appearance and abnormalities that may be seen related to size, shape, color, distribution, and inclusions. Key points include that normal red blood cells are biconcave discs that appear reddish at the periphery and pale in the center, and abnormalities may indicate diseases related to plasma proteins, erythropoiesis, hemoglobin formation, cell damage, or increased erythropoiesis. Specific abnormalities described include microcytosis, macrocytosis, hypochromia, poikilocytosis, spherocytes, and inclusions like Howell-Jolly bodies.
This document discusses anemias and provides classifications. It defines anemia as a decrease in hemoglobin levels below normal for age and sex. Anemias are classified based on red blood cell size and hemoglobin content into microcytic hypochromic, macrocytic, and normocytic normochromic types. Microcytic hypochromic anemia involves small red blood cells with low hemoglobin and is seen in iron deficiency, thalassemia, and chronic disorders. Macrocytic anemia involves large red blood cells with low hemoglobin and occurs in megaloblastic anemia and liver disease. Normocytic normochromic anemia has normal sized red blood cells but low overall hemoglobin, as seen
This document discusses anticoagulants, which are chemical agents that prevent blood from clotting. It describes the properties anticoagulants must have and classifications, including calcium chelators like oxalates, EDTA, and trisodium citrate, as well as non-calcium chelators like heparin. It provides details on commonly used anticoagulants like EDTA, oxalates, trisodium citrate, and heparin, and how they work to prevent clotting through binding calcium or other mechanisms. The document also notes anticoagulants used to preserve blood for storage in blood banks.
Hemoglobin is the red pigment found in red blood cells that carries oxygen from the lungs to tissues and carbon dioxide from tissues back to the lungs. It is a conjugated protein made up of an iron-containing heme group and a globin protein. Each hemoglobin molecule contains four heme groups with iron atoms that can each bind one oxygen molecule. There are different types of hemoglobin including adult hemoglobin A, fetal hemoglobin, and pathological hemoglobins involved in conditions like sickle cell disease and thalassemia. The structure and function of hemoglobin allows it to efficiently transport oxygen and carbon dioxide in the bloodstream.
This document discusses hematopoiesis, the formation of blood cells. It begins by describing the components of blood, including formed elements like red blood cells, white blood cells, and platelets. It then explains the stages of blood cell development, or hematopoiesis, including erythropoiesis, leukopoiesis, granulopoiesis, and thrombopoiesis. The document discusses where hematopoiesis occurs, including the primary organs of bone marrow and thymus and secondary organs like the spleen. It also covers hematopoiesis during prenatal development and in adulthood. In summary, the document provides an overview of the components of blood and the process by which blood cells are formed
The document summarizes key information about blood, including:
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- Red blood cells contain hemoglobin and transport oxygen and carbon dioxide. White blood cells help combat pathogens and foreign substances. Platelets help form blood clots during hemostasis.
- Blood functions include respiration, nutrient and hormone transport, waste removal, pH regulation, temperature control, water balance, and protection from pathogens through white blood cell activity and hemostasis.
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- Hematology is the study of blood, blood forming tissues, and their disorders.
- Blood functions to transport nutrients and oxygen throughout the body, remove waste, and help fight infections.
- The main components of blood are plasma, red blood cells, white blood cells, and platelets. Plasma is the liquid portion that carries the blood cells.
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3) Different types of microscopes including brightfield, darkfield, phase contrast, and fluorescent microscopes and how they produce images.
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2. ANEMIAS CAUSES
The main causes (often interacting) of anaemia in tropical countries are:
● Malnutrition, associated particularly with:
• Iron deficiency anaemia. Iron deficiency is the commonest form of
anaemia and a major health problem in tropical countries.
• Folate deficiency (less commonly, vitamin B12 deficiency)
• Protein deficiency
3. TO BE CONTIN................
• Parasitic, bacterial, and viral infections, particularly:
• Falciparum malaria, hyperreactive malaria, splenomegaly Malaria is
the commonest cause of death from anaemia in young children in
tropical countries.
• Hookworm infection Tuberculosis and other chronic infections
• HIV disease/AIDS and treatment with antiretroviral drugs such as
zidovudine .
• Visceral leishmaniasis
• African trypanosomiasis
• Less commonly, parvovirus B19 infection and viral haemorrhagic
fever diseases.
5. MECHANISIM OF ANAEMIA
BLOOD LOSS
● Acute bleeding, e.g. from wounds, surgical, ectopic pregnancy, placenta praevia
● Chronic blood loss, e.g. hookworm infection, schistosomiasis, gastrointestinal bleeding,
menorrhagia
DECREASED RED CELL PRODUCTION
● Lack of essential nutrients, e.g. deficiencies of iron, folate, vitamin B12, protein
● Depressed bone marrow activity, e.g. anaemias associated with chronic disease such as
tuberculosis, HIV disease, chronic nephritis, chronic hepatitis, connective tissue disorders,
malignant disease, leukaemias
● Due to drugs, chemicals, ionizing radiation, some viruses
● Thalassaemia syndromes
6. • INCREASED RED CELL DESTRUCTION (HAEMOLYSIS)
● Inherited haemolytic anaemias
Haemoglobinopathies, e.g. sickle cell diseases, thalassaemia
syndromes.
Red cell enzyme deficiencies, e.g. G6PD deficiency, pyruvate kinase
deficiency.
Red cell membrane defects e.g. hereditary spherocytosis
7. ● Non-immune acquired haemolytic anaemias:
Infections, e.g. malaria, African trypanosomiasis, meningococcal septicaemia, C. perfringens infection, bartonellosis
– Pre-eclampsia and HELLP syndrome (haemolysis, elevated liver enzymes, low platelet count)
– Conditions which cause disseminated intravascular coagulation (DIC) – Haemolytic uraemic syndrome
– Hypersplenism and splenomegaly, e.g. visceral leishmaniasis, hyper-reactive malaria, splenomegaly, myelofibrosis
– Burns
– Venomous snake and spider bites
– Chemicals, oxidant drugs, local herbal remedies
– Paroxysmal nocturnal haemoglobi
8. ● Immune acquired haemolytic anaemias (DAT positive):
• Haemolytic disease of the newborn
• Haemolytic blood transfusion reaction
• Warm reactive autoantibody, e.g. drug-induced chronic lymphatic
leukaemia, lymphoma, systemic lupus erythematosus
• Cold reactive autoantibody, e.g. M. pneumonia infection, lymphoma –
Paroxysmal cold haemoglobinuria
9. IRON DEFICIENCY ANAEMIA
• Iron deficiency anaemia
Iron is needed to produce the haem component of haemoglobin and a
small amount is needed to produce muscle myoglobin and
cytochromes (respiratory enzymes). Insufficient iron for haemoglobin
production leads to iron deficiency anaemia.
10. Causes of iron deficiency
Causes of iron deficiency
● Intake of iron is insufficient or the iron in the diet is in a form which is not
easily absorbed, e.g. non-haem iron of plant origin (in contrast, haem iron in
meat is easily absorbed). Also, diets in tropical countries are often high in
substances which inhibit the absorption of non-haem iron e.g. phytic acid in
grain fibres. Ascorbic acid in the diet helps to absorb non-haem iron.
● Increased loss of iron due to chronic blood loss as occurs in severe hookworm
infection, schistosomiasis, trichuriasis, gastrointestinal bleeding, menorrhagia.
● Malabsorption of iron as in intestinal malabsorptive disease, e.g. acute post-
infective malabsorption (PIM).
● Increased demand for iron as occurs in the early years of life and during
pregnancy.
Note: Iron deficiency causes a microcytic hypochromic anaemia
11. DIAGNOSIS
Following investigations are to be performed for diagnosing a case of
anaemia:
• Estimation of Haemoglobin (Hb).
• Estimation of Total Red Blood Cell Count (TRBC).
• Estimation of Haematocrit (Hct) or Packed Cell Volume (PCV).
• Calculation of absolute values.
• Examination of peripheral blood film.
• Reticulocyte count
• After determining the morphological type of anaemia, the patient is
further investigated to determine the cause of it
12. Other tests to investigate microcytic hypochromic
anaemia
• Other tests to investigate microcytic hypochromic anaemia
●Serum ferritin1
●Serum iron
●TIB
●Bone marrow iron
●Haemoglobin electrophoresis
13. THALASSAEMIA SYNDROMES
• THALASSAEMIA SYNDROMES
• Thalassaemia syndromes are inherited disorders caused by a reduction in the
rate of synthesis of alpha or beta haemoglobin chains.
• Alpha thalassaemias are caused by defective synthesis of chains. Beta
thalassaemias are caused by defective synthesis of chains.
• Significant imbalance in the synthesis of alpha and beta chains leads to:
Inadequate haemoglobin production. The MCV and MCH are low and the red
cells appear microcytic and hypochromic.
• Accumulation of free uncombined globin chains in normoblasts and red cells,
causing the destruction of red cell precursors in the bone marrow (ineffective
erythropoiesis) and red cell destruction by the spleen.
14. contin...........
• The clinical severity of alpha and beta thalassaemia syndromes
depends on the thalassaemia genes inherited, and in some
syndromes, the interaction of thalassaemia genes with abnormal
haemoglobin genes, e.g. HbS, HbE, HbC. The terms thalassaemia
major, intermedia, and minor are used to describe the severity of
disease.
16. Folate deficiency and vitamin B12 deficiency
Folate deficiency and vitamin B12 deficiency
Folate (folic acid) and vitamin B12 (cobalamins) are essential for DNA
(deoxyribonucleic acid) synthesis and are therefore needed by all
dividing cells in the body, particularly haematopoietic cells in the
bone marrow. Deficiencies lead to nuclear maturation being blocked
which prevents growing cells from dividing normally (cytoplasmic
maturation is not blocked). Many precursor cells die in the bone
marrow.
Vitamin B12 is also needed to prevent degenerative changes in the
nervous system.
17. Causes of folate deficiency:
Causes of folate deficiency
● Low intake of folate in the diet (often seasonal) or more commonly, folate is inadequate
because it is destroyed when food is overheated e.g. prolonged boiling of folate rich foods
such as green vegetables, sweet potatoes, yams, plantain, peppers, meat, fish.
● Intestinal malabsorptive disease, e.g. PIM and malabsorption associated with Giardia
lamblia and Strongyloides infections. Folate absorption is also depressed in diseases such
as tuberculosis and severe pneumonia.
● High demands for folate in infancy (particularly premature infants) and childhood, during
pregnancy, and in diseases such as sickle cell disease, malaria and other haemolytic
anaemias. Also in malignant disease.
● Drugs which interfere with folate utilization, e.g. pyrimethamine, trimethoprim and
antifolate cytotoxic drugs.
18. Causes of vitamin B12 deficiency Deficiency
Causes of vitamin B12 deficiency
Deficiency Due to low intake is rare. Vitamin B12 is synthesized by bacteria and is therefore
available in foods of animal origin. The body’s daily requirement for vitamin B12 is low.
Intrinsic factor (IF), a protein secreted by parietal cells in the stomach, is essential for the
absorption of vitamin B12. The main causes of vitamin B12 deficiency are:
● Lack of IF due to gastric disease such as autoimmune gastritis (pernicious anaemia)
which damages parietal cells and prevents IF secretion.
● Intestinal malabsorption due to PIM, chronic Giardia lamblia infection and severe
enteritis.
● Rare causes include cyanide poisoning from the incorrect preparation of cassava, and
infection with the fish tapeworm Diphyllobothrium latum (competes with host for vitamin
B12).
19. Note:
Folate and vitamin B12 deficiencies cause megaloblastic
changes in the bone marrow with a macrocytic anaemia and
in the advanced stage, pancytopenia (low numbers of red
cells, granulocytes, and platelets)
megaloblastic anemias are the result of medications or
inherited defects in the transport/metabolism of vitamin B12
or folic acid. Pernicious anemia is a type of megaloblastic
anemia in which the body isn't able to absorb vitamin B12
due to a lack of intrinsic factor in stomach secretions.
20. NORMOCHROMIC ANAEMIA
NORMOCHROMIC ANAEMIA
In a normocytic normochromic anaemia the red cells appear
normocytic and normochromic in a stained blood film and the MCHC;
MCV and MCH are normal.
A normocytic normochromic anaemia may be found in:
• Acute blood loss
• Anaemia of chronic disease
• Aplastic anaemia
21. Anaemia of chronic disease
Anaemia of chronic disease Infections, malignancies, and chronic
inflammatory conditions , can cause normocytic normochromic or
microcytic hypochromic anaemia. Examination of a blood film for RBC
and leukocyte abnormalities is helpful, particularly in identifying
anaemia due to infection. Other tests to perform will depend on the
clinical findings.
22. Anaemias of infections and chronic disease
Anaemias of infections and chronic disease
• The following diseases are associated with anaemia:
Infectious diseases
• Tuberculosis
• Pneumonia
• Pulmonary abscess
• Bacterial endocarditis
• Pelvic inflammatory disease
• Osteomyelitis HIV disease
Non-infectious diseases
• Malignant disease
• Systemic lupus erythematosus
• Rheumatoid arthritis
• Other connective tissue disorder
23. Aplastic anaemia:
Aplastic anaemia
• In aplastic anaemia there is a reduction in the number of red cells,
neutrophils, and platelets in the peripheral blood (pancytopenia), low
reticulocyte count, and decrease in blood-forming tissue in the bone marrow.
• Causes of acquired aplastic anaemia include drugs (e.g. chloramphenicol,
nonsteroidal anti-inflammatory drugs, cytotoxic drugs),
• viral infection (e.g. hepatitis viruses, Epstein-Barr virus) and ionizing radiation.
• Note: Other causes of pancytopenia include HIV disease, visceral
leishmaniasis, leukaemia, multiple myeloma, myelofibrosis, megaloblastic
anaemia, myelodysplastic disorders, parvovirus, and splenomegaly.
24. Haemolytic anaemias:
Haemolytic anaemias
Haemolytic anaemias are characterized by a falling haemoglobin,
jaundice, dark urine, increasing reticulocytosis (when there is effective
erythropoiesis) and usually splenomegaly.
In tropical countries haemolytic anaemias due to both:
intrinsic causes (hereditary disorders)
extrinsic causes (acquired disorders)
both are important causes of ill health and premature death,
particularly those due to serious thalassaemia syndromes, diseases due
to abnormal haemoglobins, and haemolysis associated with malaria,
other parasitic infections, and bacterial infections.
25. Extravascular haemolysis:
In most haemolytic anaemias, haemolysis is extravascular, i.e. red cells are
destroyed by macrophages in the spleen, liver, and bone marrow. Providing liver
function is normal there is an increase in serum unconjugated bilirubin and
urine urobilinogen (urine bilirubin is negative).
Intravascular haemolysis: This is when red cells are destroyed in blood vessels
and haemoglobin is released into the circulation e.g. haemolysis following
incompatible blood transfusion, malaria haemoglobinuria, paroxysmal
nocturnal haemoglobinuria (rare complement-mediated haemolysis), or when
there is red cell membrane damage due to antibody and complement, toxic
chemicals or drugs. Laboratory findings in intravascular haemolysis include
reduced or absent serum haptoglobins, haemoglobinaemia (free haemoglobin
in the plasma), presence of methaemalbumin in plasma, and haemoglobin and
haemosiderin in urine
26. • Investigation of haemolytic anaemia,
the serum/plasma appears yellow due to increased bilirubin. A clinical
history and examination of a blood film can help to establish the
possible cause of a haemolytic anaemia and indicate the need for
further tests to confirm the diagnosis and assist in treatment and
genetic counselling (when a hereditary condition is suspected).
Laboratory staff should be aware of the local distribution of hereditary
disorders, e.g. haemoglobinopathies and the common causes of
acquired haemolytic anaemias.
27. ● Blood film findings:
• Red cells are usually normochromic. Microcytic hypochromic cells are found in thalassaemia and when there is
accompanying iron deficiency anaemia.
• Polychromasia (indicating reticulocytosis) is present in most haemolytic anaemias when there is an effective
erythropoietic response.
• In malaria, reticulocytes are only slightly increased in the early stages of infection. Anaemia in malaria is
multifactorial. It includes bone marrow suppression in addition to haemolysis.
• Sickle cells which are typically seen in sickle cell anaemia, HbSC disease, HbS thalassaemia .
• Malaria parasites in red cells, often with malaria pigment in leukocytes.
• Trypanosomes in blood film .Acute African trypanosomiasis is a cause of rapidly progressive haemolytic anaemia.
• Spherocytes which may be seen in C. perfringens septicaemia, serious burns, bartonellosis, in G6PD deficiency
(during haemolytic crisis), acquired immune haemolytic anaemia due to warm reactive autoantibody, ABO
haemolytic disease of the newborn, in haemolytic uraemic syndrome (rare) and typically in hereditary
spherocytosis (inherited red cell membrane disorder).
• Nucleated red cells, which can be seen in sickle cell disease,
• thalassaemia major and intermedia disease ,C. perfringens septicaemia, haemolytic disease of the newborn, and
autoimmune haemolytic anaemias (due to warm reacting antibody).
• Red cell fragments (schistocytes) which are seen when red cells are damaged, e.g. in burns, disseminated
intravascular coagulation, pre-eclampsia, and in microangiopathic
28. conti..............
• anaemia associated with Gram negative septicaemia and less commonly,
artificial heart valves.
• ‘Bite’ and ghost cells which can be seen during a haemolytic crisis caused by
G6PD deficiency (Heinz bodies may also be seen in a reticulocyte preparation,
• Target cells which are seen particularly in thalassaemia syndromes , sickle cell
disease, HbC disease, liver disease.
• Basophilic stippling, which is most frequently seen in thalassaemia
syndromes .
• Marked red cell agglutination (clumping due to antibody-coating) of red cells
which is seen in immune haemolytic anaemia due to cold reacting
autoantibody (unless blood sample is kept at 37C).
• Bartonella organisms in red cells, causing Oroya fever .
29. Other tests to investigate haemolytic anaemia
• Reticulocyte count, see To assess erythropoietic
●Sickle cell slide test or If sickle cell disease is solubility test,
●Haemoglobin To demonstrate HbS, electrophoresis, HbC or other abnormal To detect raised HbA2 and HbF if
thalassaemia syndrome is suspected .
●G6PD screening test,
●Direct antiglobulin test If immune haemolytic (DAT) using broad anaemia is suspected. spectrum serum, see Positive
DAT is found
• Warm reacting autoantibody (IgG, complement)
• Cold reacting autoantibody (IgM)
• Drug induced autoantibody, e.g. methyl dopa, penicillin, cephalothin quinidine, chloramphenicol
• Haemolytic disease of the newborn
• Incompatible haemolytic blood transfusion reaction
30. contin.............
●Test to detect RBC membrane defects: If red cell membrane
disorderis suspected, e.g. hereditary spherocytosis, paroxysmal
nocturnal haemoglobinuria.
– Autohaemolysis test
– Osmotic fragility
– Glycerol lysis test
– Ham’s test