Aplastic and secondary anaemia

Question 1

what are the characteristic features of anaemia of chronic disorders?

Answer 1

• normo-chromic, normocytic or mildy hypochromic
• mild and non-progressive anaemia
• both serum iron and TIBC reduced
• serum ferritin is normal or raised
• bone marrow storage iron is normal but erythroblast iron is reduced

Question 2

what happens to the MCV/MCH in chronic inflammation or malignancy?

Answer 2

normal or mild reduction

Question 3

what are the causes of pancytopenia?

Answer 3

• Decreased bone marrow function e.g. during an acute infection
• Aplastic anaemia
• Acute leukaemia, myelodysplastic syndromes
• Infiltration with lymphoma, myeloma, metastatic solid tumours, tuberculosis
• Megaloblastic anaemia
• Paroxysmal nocturnal haemoglobinuria
• Myelofibrosis, both primary (myeloproliferative neoplasm) and reactive
• Haemophagocytic lymphohistiocytosis
• Increased peripheral destruction (e.g. due to a microangiopathic process)
• Splenomegaly