Benign RBC Disorders Flashcards
Normal component of BM
50% cellular
50% fat
Normal constit of cellular marrow
65% granulocytes
25% RBCs
10% lymphs, monos, and precursors
Neutrophilic leukocytosis
acute bacterial inf
sterile inflamm d/t tissue necrosis (MI, burns)
Eosinophilic leukocytosis
allergic disorders parasitic inf drug reactions collagen vascular disorders / some vasculitides atheroembolic disease (xsient) certain malig
Basophilic leukocytosis
rare –> ind of myeloproliferative disease
Monocytosis
chronic infections bacterial endocarditis rickettsiosis, and malaria collagen vascular diseases (e.g. SLE) IBD
Neoplastic prolif of RBCs
leukemias
Polycythemia vera
thrombocytosis
Sites of hematopoiesis
3rd wk –> yolk sac in mesoderm
3rd month of fetal life –> liver
4th month –> BM
by 18yo –> restricted to long bones and axial skeleton
pronormoblast
- first recognizable cell of RBC lineage
basophilic normoblast
- baso cyto d/t ribosomes and active protein synth
polychromatophilic normoblast
- cyto more pink d/t Hb
more condensed chromatin
orthochromic
- orange/red cyto
pyknotic
non-dividing nucleus
reticulocyte
- anucleate RBC
methylene blue stain to see ribos
CFU-E
erythropoieting receptor on erythroid precursor cells
Acute anemia of blood loss
loss of blood volume
hemodilution –> shift of water from interstitial fluid
reduction on O2 triggers erythropoietin prod
reactive thrombocytosis and leukocytosis
reticulocyte count inc 10-15% after 7d
Chronic anemia of blood loss
blood loss exceeds regenerative capacity OR
iron preserves are depleted
Morpho features of Hemolytic anemias
inc normoblasts in BM
reticulocytosis in periph blood
cholelithiasis
hemosiderosis
Intravascular Hemolytic Anemia
mechanical injury, C' fixation, or exogenous toxic factors hemoglobinemia hemoglobinuria jaundice and hemosiderinuria low haptoglobin
Extravascular hemolysis
injury to red cells, rendered “foreign”, or becoming less deformable
Hereditary Spherocytosis
- -AD
- -intrinsic defect in red cell membrane
- -def in spectrin –> reduced membrane stability and spontaneous loss
- -inc osmotic fragility
- -spherocytes are less deformable
G6PD deficiency
abnormal HMP shunt or glutathione metab X-recessive heinz bodies --> bite cells hemoglobinuria chronic non-spherocytic hemolytic anemia
Sickle Cell Disease
–pt mutation = valine for glutamic acid @ 6th position of beta-globin chain
deoxygenation = HbS aggregate, polymerize, and sickle
inc Hb release –> inc bilirubin
capillary stasis and thrombosis
Sickle Cell Disease pathology
BM : erythroid hyperplasia can experience extra medullary hematopoiesis adults have small spleen cor pulmonale leg ulcers pigment gallstones infarction secondary to vasc occlusion
Sickle Cell aplastic crisis
Parvovirus B19
infects RBC progenitor and interrupts production