Classification of Anemia Flashcards
What is Anemia?
Anemia refers to a low oxygen carrying capacity of your blood due to decrease hemoglobin (Hb) concentration, which may caused by: bleeding , hemolysis or decreased normal RBC production.
What is the WHO criteria for Anemia?
Men:Hb< 13 g/dL
Women:Hb< 12 g/dL
Pregnant women:Hb< 11 g/dL
Children:
* * 6months-4years <11g/dL
* * 5–11 years:< 11.5 g/dL
* * 12–14 years:< 12.0 g/dL
What is the morphological classification of anemia?
- Microcytic anemia
- Normocytic anemia
- Macrocytic anemia
What are the normal values of:
Mean cell volume (MCV)
Mean cell hemoglobin (MCH)
Mean cell hemoglobin concentration (MCHC)
MCV: 80-100fL
MCH: 27-31pg
MCHC: 32-36mg/L
What are the causes of Microcytic anemia?
- Iron Deficiecy Anemia (IDA)
- Anemia of chronic disease (ACD)
both of which can manifest as Normocytic anemia in early stage, then Microcytic anemia in later stage. - Sideroblastic anemia
- Lead poisoning
- Thalassemia
Normocytic anemia can be classified into?:
- Extrinsic Hemolytic anemia
- Intrinsic Hemolytic anemia
- Non-Hemolytic anemia
Intrinsic Hemolytic anemia is caused by?:
- Hemoglobin defects, like in the case of:
* Sickle cell Disease (SCD)
* Hemoglobin C Disease
* Thalassemia - RBC membrane abnormalities, like in the case of:
* Hereditary spherocytosis
* Paroxysmal Nocturnal Hemoglobinuria (PNH) - Enzyme deficiencies, like in the case of:
* Pyruvate kinase deficiency
* Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency
Nonhemolytic normocytic anemia is caused by?
- Aplastic anemia
- Anemia of chronic kidney disease
- Acute Blood loss
- Anemia of chronic disease
- Iron deficiency anemia
- Dilutional anemia of pregnancy
What is Intrinsic and Extrinsic Hemolytic anemia?
In:
Intrinsic Hemolytic Anemia: RBCs are destroyed because they are defective
Extrinsic Hemolytic Anemia: RBCs are normal but are later destroyed outside the bone marrow
Extrinsic Hemolytic Anemia can be further classified into?
1) Intravascular Hemolytic Anemia: RBCs destroyed in blood vessels
2) Extravascular Hemolytic Anemia: RBCs destroyed in liver and spleen by macrophages
Intravascular Hemolytic Anemia includes?
a. Microangiopathic Hemolytic Anemia
b. Macroangiopathic Hemolytic Anemia
Extravascular Hemolytic Anemia includes?
Autoimmune Hemolytic Anemia
What is Microangiopathic Hemolytic Anemia and what is it caused by ?
Microangiopathic Hemolytic Anemia refers to RBCs destroyed in small blood vessels, and is caused by:
* Thrombotic Thrombocytopenic Purpura (TTP)
* Hemolytic Uremic Syndrome (HUS)
* Disseminated Intravascular Coagulation (DIC)
* HELLP Syndrome
* Hypertensive Emergency
* Drugs like: Quinine, Trimethoprim/Sulfamethoxazole, Cyclosporine
* Autoimmune diseases (e.g. SLE)
What is Macroangiopathic Hemolytic Anemia?
Macroangiopathic Hemolytic Anemia refers to RBCs destroyed in larger blood vessels as they squeeze pass damaged heart valves, like in Aortic Stenosis or Prosthetic heart valves. Or due to repetitive exercises that cause mechanical damaged. i.e., Exertional hemoglobinuria (marching hemoglobinuria)
What is Autoimmune Hemolytic Anemia?
Antibodies and compliment proteins target and destroy RBCs. Based on the type of antibody, it can be divided into 2 types:
1) IgG / Warm Antibody Hemolytic Anemia
2) IgM Hemolytic Anemia / Cold Agglutinin Disease
