Classification of anemia Causes of anemia Red cells
- Slides: 12
Classification of anemia Causes of anemia Red cells size and their indices -Blood loss. -Hb concentration and Hematocrit -Iron deficiency. -MCV, MCHC. -Infection. -RBC destruction (hemolysis) e. g. G 6 PD. -B 12 and Folate deficiency. MCV -IDA -Thal CV M Normal MCV -B 12 -Folat -hemolytic anemia
Iron deficiency anemia Normal iron metabolism: -The primary function is oxygen transport. -Iron is absorbed by duodenum and jejunim -Average total body iron content 3500 -4000 mg. -Approximately 2/3 found in hemoglobin, -Iron is also stored in RE cells (BM, Spleen and liver) as hemosiderin and ferratin. -Also iron found in myglobin and myeloperoxidase and in certain electron transfer. -Iron is more stable in ferric state (Fe+++) than in ferrous state (Fe++).
Iron + Hem Iron Metabolism
Daily Fe++ turnover continuous process RBC 2500 mg Via RE system 90% extra vascular 5 -10% intra vascular R. E. 20 mg Released daily Iron Absorption 1 -2 mg only Plasma Fe Transferrin carriers 4 mg 20 mg Fe Returned to immature RBC in BM Loss (from GI tract) 1 -2 mg daily Body stores 1000 mg (M) 300 -500 mg (F) Myglobin 300 mg
Dietary iron: Iron is present in food as ferric hydroxides (ferric-protein complexes and hem-protein complexes). -meat, liver -vegetables, eggs. -The average diet contains 10 -15 mg and only 5 -10% is normally absorbed. Iron requirements: It varies depending on sex and age: Male/female 0. 5 -1 mg/day Pregnant female 1 -2 mg/day Children 0. 5 mg/day
Clinical features: • • When ID is developing, the RE stores (hemosiderin and ferritin) become completely depleted before anemia occurs. At an early stage, no clinical abnormalities. Later, patient may develops general symptoms and signs of anemia. In severe case of IDA ridged or spoon nails.
Causes: • Chronic blood loss Fetomaternal Hemorrhage, inherited bleeding disorders menstrual peroid. • Maternal iron deficiency (neonate). • Growth spurts (infants and children). • Gastrointestinal, peptic ulcer, aspirin ingestion, carcinoma, hookworm, colitis, piles etc. • Pregnancy • Rarely hematouria, self-inflicted blood loss, hemoglobinuria. • Insufficient daily iron intake (poor diet). • Malabsorption.
Laboratory findings: • Red cell indices: Low Hb conc. MCV, MCHC* • Blood film: Hypochromic microcytic Picture. Occasional Target cells. Pencil shaped poikilocytes. Normal reticulocyte count. • Bone marrow iron: Normal to hypercellular. RBC precursors are increased in number. Iron stain negative. • Chemical testing on serum: Serum iron Decreased Transferrin/TIBC Normal to High Serum ferritin Decreased (Very low)
Hypochromic Microcytic picture (IDA) -ve BM Iron Stain +ve
Reticulocytes
- Red blood cells and white blood cells difference
- Megaloblastic anemia vs pernicious anemia
- Polycythemia differential diagnosis
- Causes of megaloblastic anaemia
- Megaloblastic anemia causes
- Microcytic anaemia tails
- Intracorpuscular hemolytic anemia
- Chronic hemolysis
- Sickle cell hemoglobin structure
- Onodi cells
- Medullary portion of collecting duct
- Thyroid parafollicular cells
- Gametes vs somatic cells