Clin Path: Hemolytic Anemia Flashcards
Which type of anemia should you particularly look at a blood smear?
hemolytic anemia
What is the number 1 cause of hemolytic anemia?
immune-mediated hemolytic anemia
Autoimmune immune mediated hemolytic anemia can be either _______ or _________
primary (nonassociative or idiopathic)
secondary (associative)
In secondary autoimmune hemolytic anemia what are the antibodies forming against?
infection
neoplasms
drugs
What are common signalments for primary IMHA although it can occur in any species or breed
dogs»>cats
young to middle aged
predisposed breeds
Upon obtaining a history and performing a physical exam, what would you see in a typical case of an animal with IMHA
-megaly such as lymphoadenomegaly, splenomegaly, hepatomegaly
v,d
polyuria and polydipsia
fever
On a blood smear if you see ghost cells, spherocytes, and RBC agglutination what would be your diagnosis?
IMHA
What are spherocytes?
cells without central pallor
Describe the difference between agglutination and rouleaux
agglutination is the clumping of cells in the monolayer when they are supposed to be spread out. Rouleaux is the lining up of cells due to increased plasma proteins from electrostatic charges of globulin (+) and RBC (-)
If you found rouleaux in a dog what would you think? What about a horse?
Incidental finding in horses whereas if seen in dogs it would be a sign of inflammation and therefore point to IMHA
What is the pathogenesis of infectious hemolytic anemia?
Direct RBC lysis
expose hidden antigens
Is infectious hemolytic anemia associative or nonassociative?
associative
What is the signalment for infectious hemolytic anemia?
cat, cattle»_space;» dog, horse
What are the differences in history and PE of IMHA vs infectious hemolytic anemia?
similar
-megaly
v/d
polyuria, polydipsia
fever
In cats, what bacteria will you see in the case of infectious hemolytic anemia? What about in cattle?
mycoplasma in cats and anaplasma in cattle
What is a howel jolly body?
histological change seen on blood smear - pieces of nuclear DNA from RBC
What are the different types of protozoa seen in blood smears of infectious hemolytic anemia and the species it is seen in?
cytauxzoon in cat
Babesia in dog
Theileria in cattle
How would you histologically describe protozoa?
Loop/hairpin structure
What is the pathogenesis of oxidative hemolytic anemia?
toxin ingestion, drug admin leading to oxidative RBC injury
What species is oxidative hemolytic anemia seen in and what toxins cause it?
dogs - onions, garlic, zinc
cats- acetaminophen (Tylenol)
horses - maple leaves
sheep - copper
Upon history and PE what would you find in a patient with oxidative hemolytic anemia?
toxin/drug exposure
hemolytic anemia
chocolate brown blood
In oxidative hemolytic anemia, what is injured?
iron of hemoglobin
globin of hemoglobin
RBC membrane
What clinical findings are associated with oxidative hemolytic anemia?
methemoglobinemia
Heinz bodies
Eccentrocytes
What two clinical findings are pathognomic for oxidative hemolytic anemia?
Heinz bodies
eccentrocytes
What is methemoglobinemia and is it reversible?
Iron heme group of hemoglobin is oxidized (electron removed)
–> Fe3+
It is reversible
Are Heinz bodies and eccentrocytes reversible?
negative
In what species would finding a small amount (<10%) of Heinz bodies be accidental?
Cats
If you find Ghost cells, Heinz bodies, recticulocytes, and anemia what would your diagnosis be?
Oxidative hemolytic anemia
What are eccentrocytes?
membranes stick together
What are inciting conditions that would cause fragmentation hemolysis?
iron deficiency
hemangiosarcoma
thrombus
disseminated intravascular coagulation (DIC)
heart valve disease
What is the pathogenesis of fragmentation hemolysis?
fragile RBCs
microangiopathy (dx in small blood vessels) –> turbulence causes fragmentation
What are three types of fragmentation caused by hemolysis?
acanthocytes, keratocytes, schistocytes
