Anaemia of Chronic Disorders

Question 1

What are the Characteristic Features of Anaemia with Chronic Disorders?

Answer 1

1.Normochromic, normocytic or mildly hypochromic (MCV rarely <75 fL) indices and red cell morphology.

2. Mild and non-progressive anaemia (haemoglobin rarely <90g/L) – the severity being related to the severity of the underlying disease.
3. Both the serum iron and TIBC are reduced.

4.The serum ferritin is normal or raised.

5. Bone marrow storage (reticuloendothelial) iron is normal, but erythroblast iron is reduce

Question 2

What are the causes of Anaemia of Chronic Disorders?

Answer 2

• Chronic inflammatory diseases.
• Infections (e.g. pulmonary abscess, tuberculosis, osteomyelitis, pneumonia, bacterial endocarditis)
• Non-infectious (e.g. rheumatoid arthritis, systemic lupus erythematosus and other connective tissue diseases, sarcoidosis, inflammatory bowel disease)
• Congestive heart failure
• Chronic pulmonary disease
• Chronic renal disease
• Obesity
• Malignant diseases
• Carcinoma, lymphoma, sarcoma.

Question 3

True or False? Iron refractory iron deficiency anaemia
(IRIDA) is a rare autosomal dominant disease.

Answer 3

FALSE!! It is a Rare autosomal RECESSIVE case of hypochromic microcytic anaemia

Question 4

Fill in the blanks . “ Iron refractory deficiency disease is caused by an inherited mutation in ___________.”

Answer 4

• Matripase 2 (which allow uninhibited hepcidin secretion)
• DMT-1 rarely

Question 5

What happens to the Serum Ferritin levels in IRIDA?

Answer 5

It is INCREASED.

Question 6

True or False? In IRIDA the serum iron and TIBC are both REDUCED.

Answer 6

TRUE!!

Question 7

What is the main characteristic of Sideroblastic Anaemia?

Answer 7

Ring Sideroblasts in the bone marrow.

Question 8

What is the diagnostic criteria for Sideroblastic Anaemia?

Answer 8

Sideroblastic anaemia is diagnosed when 15% or more of marrow erythroblasts are ring sideroblasts.

Question 9

In hereditary sideroblastic Anaemia , what is the common mutation ?

Answer 9

The most common mutations are in the ALA-S gene, which is on the X chromosome.

Question 10

What is the name of the enzyme that is a co-enzyme for ALA- S enzyme?

Answer 10

Pyridoxal-6-phosphate

Question 11

What is another type of Hereditary Sideroblastic Anaemia?

Answer 11

• X-linked disease with spinocerebellar degeneration and ataxia.

*Mitochondrial defects (e.g. Pearson’s syndrome, when there is also pancreatic insuf- ficiency)

• Thiamine-responsive and other autosomal defects.

Question 12

Fill in the blanks. “ Refractory anaemia with ring sideroblasts is a subtype of ___________.”

Answer 12

Myelodysplasia

Question 13

What is the treatment for Hereditary sideorblastic anaemia?

Answer 13

Pyrodoxine Therapy

Question 14

What is the pathogenesis of Lead poisoning?

Answer 14

It interferes with the breakdown of RNA by inhibiting the enzyme pyrimidine 5′ nucleotidase, causing accumulation of denatured RNA in red cells, the RNA giving an appearance called basophilic stippling

Question 15

What is the stain used to identify basophilic stippling in Lead poisoning?

Answer 15

Romanowsky stain

Question 16

What type of cells may be found in patients with Lead poisoning?

Answer 16

Sideroblasts

Question 17

Fill in the blanks. “ In lead poisoning ______________ is raised.”

Answer 17

Free erythrocyte protoporphyrin

Question 18

Fill in the blanks.” Beta Thalassemia trait is characterised by a raised __________.”

Answer 18

β-Thalassaemia trait is characterized by a raised Hb A2 above 3.5%

Question 19

True or False? In thalassamia trait ,the red cell count is usually OVER 5.5×10 12/L.

Answer 19

TRUE!!