Anaemia Approach Flashcards
What are the two definitions for anaemia?
reduction in haemoglobin conc. below that which is optimum for that individual or below 95% range for the population
What size of RBC is seen with hypoproliferative anaemia?
normocytic normochromic
What is reticulocyte count a marker of?
red cell production
How can the causes of anaemic reticulocytosis be differentiated?
if bleeding- RBCs are lost, but haemolysis- increased uncojugated bilirubin and LDH; urinary urobilinogen
How much can normal marrow increased red cell production by?
3-4 fold
What is the most common cause of microcytic anaemia?
iron deficiency
What are the other causes of microcytic anaemia?
thalassaemia; anaemic of chronic disease; lead poisoning; pyridozine responsive anaemias; sideroblastic anaemia
What are the causes of non-megaloblastic macrocytic anaemias
myelodysplasia; myeloma; aplastic anaemia; reticulocytosis; cold agglutinins
What are the causes of macrocytosis without anaemia?
alcohol; liver disease and hypothyroidism
What are the causes of hypoproliferative normochromic normocytic anaemias?
chronic disease; anaemia of renal failure; hypometabolic states (hypothyroidism
); marrow failuire
What is the second most common cause of anaemia world-wide?
anaemia of chronic disease
What is the central process of anaemia of chronic disease?
inflammation
Inflammation activates monocytes and T cells to produce cytokines, how does this contribute to the development of anaemia?
cytokines —increase heptic synthesis of hepcidin which inhibits iron release from macrophages; inhibit erythropoietin release and erythroid proliferation and augment haemophagocytosis
What cytokine is mainly involved in the release of hepcidin from hepatocytes?
IL-6
What are the actions of hepcidin?
inhibits macrophage iron release and intestinal iron absorption
