Hypochromic Anemia PK 14 88 Anemia 3 Laboratory

Hypochromic Anemia 진단검사의학과 PK 14조 88번 장효정

Anemia (3) Laboratory Findings in Anemia Leukocyte & Platelet count : 순수한 빈혈과 범혈구감소증의 구분 Reticulocyte count : Anemia시 증가 증가하지 않으면 – 골수기능장애나 EPO자극의 부족 의심

Anemia (4) Blood film 비정상적인 적혈구 모양 적혈구 봉입체 Bone Marrow Examination Aspiration Biopsy

IDA (2) Physiology of Iron Transport & Distribution

IDA (3) Causes of Iron Deficiency

IDA (5) Severe iron deficiency anemia. Microcytic and hypochromic red cells smaller than the nucleus of a lymphocyte associated with marked variation in size (anisocytosis) and shape (poikilocytosis). (From Hillman and Ault. )

Sideroblastic Anemia (1) Heme incorporation의 장애로 Hb형성이 감 소된 질환 Iron이 Mitochondria에 축적(Total body iron의 증가) Developing RBC 핵주위에 Iron-laden mitochondria가 분포(ringed sideroblast) Pyridoxin(Vt. B 6) responsive anemia

Sideroblastic Anemia (2) 원인 1. Hereditary or Congenital Sideroblastic Anemia 2. Acquired Sideroblastic Anemia Drugs & Toxins(예: Alcohol, lead, INH, PZA, Chloramphenicol) Neoplastic(예: Carcinoma, leukemia, lymphoma) Inflammatory disease, RA Alkylating agent chemotherapy(예: cyclophosphamide)

Sideroblastic Anemia (4) Tx. 1. 2. 3. 4. 기저질환의 치료, offending drugs & toxins 중단 Pyridoxine(Vt. B 6), folic acid Androgen, GM-CSF, IL-3, erythropoietin Transfusion등의 supportive therapy

References Nancy C. Andrews. Disorders of Iron Metabolism; New England Journal of Medicine. 1999; 34; 1986 -1996 Guenter Weiss et al. Anemia of Chronic Disease; New England Journal of Medicine. 2005; 352; 1011 -1023 Harrison’s Principls of Internal Medicine. 16 th edition. volume 1; 330 -336 Hoffbrand et al. 핵심혈액학(Essential Heamatology); 13 -41