BLI 6 - Microcytic Anemia (Siddiqui) Flashcards
Increase in HbF
beta-thal major
Clinical manifestations of lead poisoning
L: Lead lines on gingivae & metaphyses of long bones
E: Encephalopathy, Erythrocyte basophilic stippling
A: Abdominal colic, sideroblastic Anemia
D: Drops - wrist and foot drop, Dimercaprol and EDTA 1st line of tx
Koilonychia (spoon nails)
iron deficiency anemia
whole gene deletions, asymptomatic, mild microcytic anemia
alpha-thal minor
Alcohol poisons mitochondria B6 deficiency due to isoniazid
Acquired sideroblastic anemia
thalassemia - africans
Trans-deletion
EPO - down
Hepcidin - up
ACD
Labs for iron deficiency anemia:
- Serum iron
- %sat -Serum ferritin
- FEP (free erythrocyte protoporphyrin)
- sTfR (soluble transferrin receptor) - TIBC
Serum iron - down
TIBC - up
%sat - down
FEP - up
Serum ferritin - down
Lab results for ACD:
- Serum iron
- Serum ferritin
- %sat -sTfR (TIBC)
- FEP
Serum iron - N to down
Serum ferritin - up
%sat - N to down
sTfR - down (always opposite ferritin)
FEP - up
Incompatible with life – Hydrops fetalis
Hb Barts (homozygous alpha-thal)
- “all 4” alpha mutated
- excess gamma forms tetramers
whole gene deletions, symptomatic, hemolytic and microcytic anemia, splenomegaly
Hb H Disease (alpha-thal)
- transfusion dependent
- “3 of 4 alpha” mutated
- excess beta globin forms tetramers = Hb H
Koilonychia Pallor of skin/face Conjunctival pallor Palmar pallor Atrophic glossitis
IDA
Lab results for sideroblastic anemia:
- Serum iron
- TIBC/sTfR
- %sat
- Serum ferritin
Serum iron - up (accumulates as ring sideroblasts)
TIBC/sTfR - down
%sat - up
Serum ferritin - up
Iron sequestered in macrophages
Chronic inflammation
Mutation in ALAS
Sideroblastic anemia
Menstruation Childbirth GI disease
IDA - chronic blood loss
IDA + Esophageal webs + atrophic glossitis
Plummer-Vinson syndrome
Increase in Hb A2
beta-thal minor
X-linked
Sideroblastic anemia
Lead poisoning
Acquired sideroblastic anemia
RA, SLE, IBD, cancer
Increased hepcidin
ACD