Classification of Anaemia Flashcards
how can anaemia be classified
1) by the morphology of RBC
2) if there is an appropriate response by reticulocytes tot he present pathology
what would an appropriate response by reticulocytes to increased RBC destruction by the spleen
more RBCs being produced to counter the loss?
is there an appropriate reticulocyte response? NO
look at MCV of the RBC on full blood count
MCV
Mean Corpuscular/ cell Volume
The MCV is a value that describes the average size of red blood cells (erythrocytes) in a blood sample
how can RBCs be described according to their MCV
Microcytic
Normocytic
Macrocytic
therefore if there is NOT an appropriate reticulocyte response what sort of anaemia could it be
Microcytic anaemia
Normocytic anaemia
Macrocytic anaemia
is there an appropriate reticulocyte response? YES
ask: is there evidence of haemolysis
is there evidence of haemolysis? YES
look fo any possible cause
- shear stress?
- heat damage/ osmotic changes?
- hereditary spherocytosis
- G6PD or pyruvate kinase deficiency
- autoimmune haemolytic anaemia
is there evidence of haemolysis? NO
look for signs of bleeding
with an appropriate reciulocye response what is seen on a blood film
reticulocytosis
reticulocytosis shsows
active bone marrow trying to replace lost RBC rapidly and is seen in:
Excessive bleeding
Splenic sequestration of RBCS
Haemolysis
if there isa. low reticulocyte count
means the bone marrow is not functioning as normal and will produce abnormal RBC
MCV is reticulocytes are markedly elevated
Reticulocytes are said to be large enough to cause an increase in mean cell volume (MCV) if the percentage is markedly elevated. This occurs in only a small group of subjects with very high reticulocyte percentages—those with chronic immune hemolytic anemia
microcytic anaemia
Low MCV <80fL
- characterised by small RBC
causes of microcytic anaemia can be summarised by which pneumonic
TAILS
Microcytic anaemia: TAILS
- Thalassemia
- Anaemia of chronic disease
- Iron deficiency
- Lead poisoning
- Sideroblastic anaemia
T
thalassaemia
A
Anaemia of chronic disease (normally normocytic)
I
Iron deficiency
L
Lead poisoning
S
Sideroblastic anaemia (the body has iron but cannot incorporate it into haemoglobin)
Normocytic anaemia
normal MCV 80-100 fL
- Size of RBC is normal
what is the pathology in normocytic anaemia
haemocrtic and haemoglobin levels are duced
cause of normocytic anaemia which cause reduced haemocrit and haemoglobin
- anaemia of chronic disease
- renal failure (no EPO)
- bone marrow failure
- acute blood loss
anaemia of chronic disease
associated with chronic infection, inflammatory and malignant disease. This leads to a reduction in serum iron levels, due to a higher amount being taken up by cells.
Macrocytic anaemia
high MCV >100 fL
- large RBC
large size of RBC in macrocytic anaemia means
there is an insufficient number of cells and also an insufficient amount of haemoglobin per cell.
causes of macrocytic anaemia
vitamin B12 or folate deficiency (substances found in diet that are needed for DNA development); liver disease; alcohol excess and some types of haemolytic anaemias.
most common type of macrocytic anaemia
megaloblastic macrocytic anaemia
megaloblastic macrocytic anaemia
his takes place when the DNA in red blood cells is produced too slowly or not enough.
which is the most common type of anaemia
normocytic
