Anaemia microcytic Part 2 Cell Abnormalities Flashcards
Describe anaemia
Reduction in haemoglobin circulating blood below what is normal for healthy person of same age and gender of an individual.
Reduction on red blood cell count RBC
And haematocrit Hct
Mechanisms that result in anaemia 4
- reduced production of red blood cells by bone marrow
- loss of blood from the body
- reduced survival of red cells in circulation (haemolysis)
- increased pooling of red cells in an enlarged spleen
Classified by mechanism and by size. Describe the sizes….
Microcytic
Macrocytic
Normocytic
What are microcytic cells?
They are small
How do we measure size of red cells
By measuring the mean cell volume of automated blood counter
What are microcytic cells like
What their cells present
They are hypochromic, very pale under the microscope.
Occasional target cells and elliptocytes
Common causes of microcytosis?
Iron deficiency anaemia
Anaemia of chronic disease
Thalassaemia
What can microcytosis be caused by?
Reduced synthesis of haemoglobin
- reduction of haem, (iron deficiency or anaemia of disease)
- reduced synthesis of globin (thalassaemia)
What are the causes of iron deficiency?
Increased blood loss
- menstrual cycle
- hookworm commonest cause worldwide
- gastrointestinal
Insufficient intake
- dietary veggie
- malabsorption- coeliac disease
- h. Pylori
Increased requirements
- pregnancy, infancy
What are the stages of iron depletion
Iron depletion
- storage iron reduced or absent
Iron deficiency
- low serum iron and transferrin saturation
Iron deficiency anaemia
- low haemoglobin and haematocrit
Clinical features of iron deficiency
Palor, fatigue and breathlessness
Failure to thrive, impaired intelectual development in children
Koilonychia, glotitis, inflammation of corners of mouth, angular dermatitis
Causes of anaemia of chronic disease? 5
Usually inflammation aspect
Rheumatoid arthiritis Autoimmune disease Malignancy Kidney disease Infections of TB or HIV
How is iron best absorbed in what form?
The Fe 2+ (animal products) ferrous is better than the 3+ (veggies) ferric
Why do we need iron homeostasis ?
No way to excrete iron by ourselves. (Little lost on skin and GI tract.
1-2mg per day
Excess is toxic to the heart and the liver
What is and what is the purpose of hepcerin?
Released by the liver
Controls absorption of iron
If amount of iron increases then so does hepcerin.