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Clinical Pathology > Erythrocytes > Flashcards

Erythrocytes Flashcards

1
Q

Erythron

A

All erythroid cells in an animal

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2
Q

Erythropoiesis

A

Part of hematopoiesis

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3
Q

EPO

A

Produced by fetal liver and adult kidney

- renal peritubular interstitial cells in response to hypoxia

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4
Q

Hypoxia

A
  • anemia
  • poor oxygenation of the blood
  • decreased renal perfusion
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5
Q

Hypoxia increases ______

A

EPO

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6
Q

Increasing _______ signals cells to stop dividing

A

Hemoglobin concentration

  • RNA produced for protein synthesis including Hgb
  • maturation leads to nucleus extrusion in mammals
  • reticulocyte is a erythrocyte without nucleus but with high concentration of RNA
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7
Q

Erythroid destruction in health

A

Old erythrocytes loose metabolic ability to keep deformability

  • expose hidden antigens in the membrane
  • naturally occurring antibodies bind to these antigens and mediate erythrocyte destruction
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8
Q

Hemoglobin

A

Tetramer of 4 globin molecules and bound to an internal heme

  • heme has ferrous iron
  • if ferric is attached, it cannot transport O2
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9
Q

CO2 from tissues

A

About 20% bind to Hgb

  • rest reacts with H2O to form H and HCO3
  • reaction is reversed in the lungs and CO2 is excreted
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10
Q

Porphyria

A

Increased concentration of porphyrins in erythrocytes, plasma or urine
- can be acquired (lead toxicity), or congenital

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11
Q

Iron

A
  • 50-70% erythrocytes, 25-40% storage, and rest in other molecules
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12
Q

Absorption of iron is regulated by ________

A

Hepcidin

  • produced by hepatocytes
  • decreases Fe absorption
  • hypoxia decreases hepcidin production (increases Fe absorption in the intestine)
  • inflammation increases hepcidin production (help to decrease Fe concentration)
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13
Q

Reticulocytes

A

Immature erythrocyte with stainable RNA

  • New methylene blue stains RNA and mitochondria –> reticulated or punctuated structure look in erythrocytes cytoplasm
  • Romanowisky will stain RNA on polychromatophilic erythrocytes (polychromatophils) blue (basophilic)
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14
Q

What are the 2 types of reticulocytes?

A

Most species all RNA rich erythrocytes will be called reticulocytes
- cats: punctuate (2-6 granules), aggregate (large aggregates)

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15
Q

Species differences with erythropoiesis

A
  • cattle and dogs: starts 3-4 days and peak 7-14 days (blood loss)
  • cats: aggregate (start at 2, peak at 4), punctate (peak 7-14 day)
  • horses: rarely have circulating reticulocytes
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16
Q

Polychromasia

A

Increased numbers of basophilic erythrocytes in the blood smear (Romanowsky)
- correspond to reticulocyte counts (dogs and cattle) and aggregate reticulocytes in cats

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17
Q

Erythrogram

A

Morphologic evaluation

  • hematocrit or PCV
  • [Hgb] always from erythrocytes, unless hemolysis or Hgb-O2 carriers
  • erythrocytes count
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18
Q

Wintrobe’s erythrocytes indices

A

MCHC (CHCM): average of 100 mL of erythrocytes

  • MCV: average erythrocytic volume
  • MCH: average [Hgb] per average sized erythrocytes
  • RDW: coefficient of variation of erythrocyte volume
  • HDW: coefficient of variation of erythrocytes [Hgb]
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19
Q

How is CHCM measured?

A

Cell counters using laser and is not sensitive to hemolysis

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20
Q

Nucleated erythrocytes

A

Counted per 100 leukocytes

  • if present, is necessary to correct leukocytes count
  • reported as #/100 WBC
  • so, if nRBC = 50/100WBC it could be a lot or few
  • if WBC = 500/uL, nRBC would be 250/uL
  • if WBC = 50,000/uL, nRBC would be 25,000/uL
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21
Q

Reticulocytes

A

Reticulocyte concentration: #/uL or #/L

  • reticulocyte percentage or reticulocyte count: # of reticulocytes per 100 erythrocytes
  • corrected reticulocyte percentage: calculated number of RP if naimal was not anemic
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22
Q

Discocytes

A

Mature normal erythrocytes

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23
Q

Rouleaux

A

Normal in some species (horses and cats)

  • caused by charges interactions
  • hyperglobinemia or hyperfibrinogenemia
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24
Q

Agglutination

A

Immune hemolytic anemia, different from rouleaux

  • will not form stacks of cells
  • saline dispersion test (1 part saline to 1 part of blood will disperse rouleaux, but not agglutination)
  • heparin in equine erythrocytes
  • RBCs may be counted as large cells
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25
Q

Rubricytosis

A

Increased numbers of nRBCs in the blood

  • appropriate: response to EPO with reticulocytosis
  • inappropriate: loss of control of nRBC release from BM
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26
Q

Inappropriate causes of rubricytosis

A
  • bone marrow damage (necrosis, inflammaiton, endotoxemia, neoplasia, hypoxia)
  • extramedulary hematopoiesis
  • splenic contraction
  • splenectomy
  • lead poisoning in dogs
  • bone marrow dyscrasia in poodles with macrocytosis
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27
Q

Central pallor

A

Central area of an erythrocyte that is more clear because it is thinner

  • increase: hypochromasia
  • decreased: abnormal shape (including spherocytosis)
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28
Q

Ghost cell

A
  • complement mediated intravascular hemolysis

- artifact

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29
Q

Hypochromic erythrocyte

A

Hypochromasia

  • increased numbers of hypochromic erythrocytes
  • decreased MCHC and CHCM
  • decreased RBC [Hgb]
  • Fe deficiency
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30
Q

Polychromatophil/reticulocyte

A

Polychromatophil is an erythrocyte with enough RNA to stain basophilic with Wright stain

  • reticulocyte is an erythrocyte with enough RNA to form aggregates of RNA when stained with NMB
  • polychromasia and reticulocytosis reflect accelerated erythropoiesis
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31
Q

Anaplasma marginale

A
  1. 5 um small coccus in the internal margin of the erythrocyte
    - usually one, but possible multiple per cell
    - causes hemolysis (immune mediated)
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32
Q

Reticulocyte concentration

A

Concentration of reticulocytes in the blood expressed in # of reticulocytes/uL
- is the preferred method for evaluating marrow response to anemia!!

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33
Q

Reticulocyte percentage

A

Percentage of erythrocytes that are reticulocytes in the blood

  • so, if there are reticulocytes for every 1,000 erythrocytes, the RP is 1%
  • RC = RP x [RBC]
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34
Q

Corrected reticulocyte percentage

A

Calculated percentage that represents the RP if the animal was not anemic but had the same RC

  • CRP = RP x (pateint’s Htc/average Hct for species)
  • average Hct for species
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35
Q

Babesia spp

A

Intracellular, oval to teardrop throphozoites

  • variable sizes (depend on species)
  • pale blue, with darker outer membrane and a purple eccentric nucleus
  • hemolysis: immune mediated, protease activity, decreased cell pliablity, oxidative damage
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36
Q

Cytauxzoon felix

A

Intracellular, oval, 0.1 to 2 um, with outer thin rim and eccentric nucleus

  • one to several/cell
  • anemia: inflammation, marrow damage, hemolysis
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37
Q

Distemper in dogs

A

Round to variably shaped, pale blue to pink, homogenous inclusions

  • 0.3 to 3 um
  • diff-quick is better to see than wright stain
  • active distemper infection
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38
Q

Mycoplasma spp of cattle

A

Rings, rods or cocci on erythrocytes surface

  • 0.3 to 3 um
  • immune hemolysis
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39
Q

Mycoplasma hemocanis

A

Thin chain or cocci

- immune hemolysis

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40
Q

Mycoplasma haemofelis

A

Thin chain of cocci, small rings, pale blue to purple

  • less than 0.1 um
  • immune hemolysis
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41
Q

Candidatus mycoplasma haemominutum

A

Cocci 0.1 to 0.2 um, individual or short chains

- immune hemolysis

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42
Q

Theileria

A

Pleomorphic piroplasma: cocci, rings rods, pears, and maltese crosses
- anemia: immune, protease, decreased cell pliability, and oxidative damage

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43
Q

Basophilic stippling

A

Regenerative anemia: persistence of ribosomal RNA

Plumbism: inhibition of pyrimidine 5’ nucleotidase

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44
Q

Heinz body

A

Exposure to oxidants

- oxidized hemoglobin precipitates

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45
Q

Howell-Jolly body

A

Increased erythropoiesis, decreased splenic function

- nuclear remnant free in the cytoplasm

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46
Q

Siderotic granules

A

Excess Fe in body, plumbism in dogs, myeloproliferative disease
- Fe accumulates in damaged mitochondria or in autophagocytic vacuoles

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47
Q

Acanthocyte (spur cell, burr cell)

A

Hemangiosarcoma, splenic, hepatic and renal disorders

- possible changes in membrane lipids or erythrocyte fragmentation

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48
Q

Codocyte (mexican hat cell)

A

Regenerative anemias, hepatic, renal, and lipid disorders

- excess membrane relative to Hgb content, possibly membrane lipid changes

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49
Q

Dacrocyte (teardrop shaped)

A

Marrow diseases (myelofibrosis, neoplasia)

  • unknown formation
  • artifact: stretching during film prep
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50
Q

Eccentrocyte (bite cell, cross bonded cells, hemighost)

A

Exposure to oxidants, G6PD or FAD deficiencies

- fusion of damaged membranes

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51
Q

Echinocyte (Burr cell)

A
  • type 1: irregularly shaped
  • type 2: regularly spaced blunt projections
  • type 3: regularly spaced pointed projections
  • erythrocyte dehydration, strenuous exercise, doxorubicin toxicosis, PK deficiency in dogs, snake venom
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52
Q

Crenated erythrocytes

A

Always an artifact

  • features of types 1-3
  • all echynocytes should be considered artifact until proven otherwise
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53
Q

Keratocyte (helmet cell)

A

Vasculitis, intravascular coagulation, hemangiosarcoma, caval syndrome, endocarditis
- trauma, oxidative injury, vesiculation have been proposed

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54
Q

Ovalocyte (elliptocyte)

A

Protein band 4:1 deficiency in dogs, myelofibrosis, idiopathic in cats, iron deficiency
- abnormal membrane proteins in hereditary forms

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55
Q

Pyknocytes

A

Exposure to oxidants

- likely formed from eccentrocytes

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56
Q

Schistocyte

A

Intravascular coagulation, vasculitis, hemangiosarcoma, caval syndrome, endocarditis
- trauma

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57
Q

Sperhocytes

A

Immune hemolysis, fragmentation hemolysis, envenomation, clostridial infections
- membrane loss due to macrophages partial phagocytosis, trauma

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58
Q

Stomatocyte

A

Young erythrocytes, hereditary stomatocytosis of dogs

- folding of excess membrane

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59
Q

Torocyte

A

Do not confuse with hypochromia!

- artifact

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60
Q

Anemia

A

Decreased Hct, [Hgb], [RBC]

  • pathological, not a disease
  • caused by loss, destruction, lack of production
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61
Q

Regenerative anemia

A

With reticulocytosis (increased numbers of reticulocytes)

  • following blood loss or erythrocyte destruction (hemolysis), erythroid neoplasia in cats, resolution of nonregenerative anemia
  • active erythropoiesis
  • blunted by other conditions
62
Q

Nonregenerative anemia

A

Without reticulocytosis (normal or decreased numbers of reticulocytes)

  • defective or reduced erythrocyte production
  • BM is not able to produce cells
  • severe associated to damage to early precursosrs
  • usually normocytic normochromic
63
Q

Reticulocytosis

A

3-4 days after EPO sitmulus (not in horses)

  • peak at 7-10 days
  • dog produces a lot of reticulocytes, cats moderate, cattle low, equine will not release
64
Q

Anemia morphologic classification based on MCV

A
  • normocytic: maturation is not defective
  • macrocytic: presence of reticulocytes or defective cells
  • microcytic: extra mitosis (Fe deficiency), fragments
65
Q

Anemia morphologic classification based by MCHC/CHCM

A
  • normochromic: Hgb synthesis is complete
  • hypochromic: Hgb synthesis is incomplete (young cells or defective synthesis)
  • hyperchromic: RBCs were not produced hyperchromic (either lost volume in vitro or artifact)
66
Q

Normocytic normochromic

A

Blood smear: uniform erythrocytes

  • most anemias begin as normocytic normochromic
  • most anemias in the horse are normocytic normochromic
67
Q

Macrocytic hypochromic

A

Blood smear: anisocytosis and polychromasia

- anemia probably due to blood loss or hemolysis

68
Q

Macrocytic normochromic

A

Blood smear: anisocytosis and possible polychromasia

  • seen in blood loss and hemolysis
  • occasionally defective erythropoiesis (FeLV, folic acid and cobalamin, erythroleukemia)
  • artifact (erythrocyte agglutination, cell swelling w/ storage, in vivo hyperosmolar state, too little blood)
69
Q

Microcytic hypochromic

A

Blood smear: microcytosis, codocytosis, hypochromasia, anisocytosis
- defective Hgb synthesis: Fe deficiency, copper deficiency, Vit B6 deficiency

70
Q

Microcytic normochromic

A
  • hepatic failure: hepatic dz, portosystemic shunt –> may see hypochromic state!
  • foals and kittens: lower MCV (also with Akitas and Shibas)
  • hereditary dz
71
Q

Normocytic hypochromic

A

Uncommon

  • inaccurate data, inadequate RI
  • possible w/ Fe deficiency
72
Q

Macrocytic hyperchromic

A

Falsely increased MCHC

- compare to CHCM

73
Q

Normocytic hyperchromic

A

Falsely increased MCHC

- compare to CHCM

74
Q

Microcytic hyperchromic

A 
Hypoosmolar plasma (cell shrinkage)
- if MCHC is falsely increased, think of other causes for microcytic anemia
75
Q

Increased MCHC/CHCM

A

Not physiologically possible! –> Hgb production stops when optimal [Hgb] is reached
- falsely increased

76
Q

If CHCM is not affected ________

A
  • hemolysis (pathological or in vitro)
  • oxyglobin
  • interferences on Hgb tests: lipid droplets in lipemic sample, markedly icteric sample, extreme leukocytosis, precipitated IgA
77
Q

If MCHC and CHCM are affected ________

A

Heinz bodies and hypoosmolar states

78
Q

When is an increased MCHC or CHCM true?

A
  • eccentrocytosis
  • pyknocytosis
  • spherocytosis
79
Q

What is the most common cause of nonregenerative anemia?

A
  • decreased RBC production

- defective erythropoiesis

80
Q

Erythrocyte life span

A

2-5 months

  • dog: 100 days (25 days to go from 40% Hct to 30% Hct)
  • cat: 70 days
  • cattle/horses: 150 days
81
Q

Does nonregenerative anemia stop RBC production completely?

A

No, animals are frequently anemic for several weeks before diagnosis

82
Q

Severity of nonregenerative anemia

A
  • duration of disease
  • degree of erythropoiesis decrease
  • presence/absence of processes that shorten RBC life span
83
Q

Nonregenerative anemia - inflammatory disease

A

AID: anemia of inflammatory disease

  • most common cause in mammals
  • mild to moderate
  • normocytic normochromic
  • any chronic disorder with inflammation will start the process (infectious/noninfectious)
84
Q

AID pathogenesis

A
  • shortened RBC survival
  • impaired Fe mobilization or utilization
  • impaired RBC production
85
Q

AID laboratory findings

A
  • normocytic normochromic
  • hyperproteinemia (y-globulins or positive acute phase)
  • BM: normal to mildly decreased erythropoiesis
  • hypoferremia
86
Q

Chronic renal disease

A

Nonregenerative anemia

  • mild to moderate
  • inadequate EPO production
  • decreased RBC life span
  • decreased BM response to EPO
  • possible hemorrhage, nutritional status
87
Q

CRD - lab findings

A

Normocytic normochromic nonregenerative anemia

  • azotemia
  • isostenuria
  • electrolyte disturbances
88
Q

Diseases causing _____________ lead to nonregenerative anemias

A

Marrow hypoplasia or aplasia of cell lineages

  • one or more BM components affected: blood vessels, reticular adventitial cells, marrow stroma, hematopoietic stem cells
  • nonreversible or reversible
89
Q

_____ and ____ are often idiopathic

A

Hypoplasia and aplasia

90
Q

Infectious agents causing bone marrow hypoplasia/aplasia

A
  • direct cell damage (myelitis)
  • suppression with bacterial septicemias
  • erlichiosis (disseminated micosis)
  • viral agents
  • protozoal infections
91
Q

Cytauxzoonosis

A

Pirpolasms in RBCs and schizonts in macrophages

  • rapid progression –> fatal
  • anemia: mild to severe
  • normocytic normochromic
  • non regenerative
  • AID and damage to BM, spleen and liver
  • post hepatic hyperbilirubinemia, bilirubinuria
  • thrombocytopenia, leukopenia (occasionally toxic changes)
92
Q

Toxicosis

A

Chemotherapeutic agents

  • estrogen
  • phenylbutazone
  • bracken fern
  • nonregenerative anemia
93
Q

Irradiation

A

Nonregenerative anemia

94
Q

Myelophtisis

A

Marrow replacement

  • myeloproliferative dz
  • lymphoproliferative dz
  • metastatic neoplasia: lymphoproliferative neoplasia, mast cell, carcinomas, nonhemic sarcomas
  • nonregenerative anemias
95
Q

_______ and ______ are nonneoplastic disorders that cause nonregenerative anemias

A
  • myelofibrosis

- osteopetrosis

96
Q

Immune-mediated nonregenerative anemia

A

Similar to aplastic anemia, but BM with left shift (erythroid series) and maturation arrest, or persistent erythroid hyperplasia and non-regenerative anemia

  • respond to immune suppressive treatment
  • occasionally Coomb’s positive
  • BM: left shift with maturation arrest, or erythroid hyperplasia (other cell lines are normal)
97
Q

FeLV

A

Selective damage erythroid series (hypoplasia or neoplasia)

  • precursor cell damage following hypoplasia
  • neoplastic transformation caused by mutations –> defective cell that will not mature properly = nonregenerative anemia
  • normocytic normochromic, or macrocytic normochromic non regenerative anemia
  • inappropriate rubricytosis, dysplastic RBCs
98
Q

Iron deficiencies

A

Chronic external blood loss or inadequate dietary Fe intake

  • microcytic hypochromic, possibly microcytic normochromic
  • nonregenerative anemia
99
Q

Copper deficiency

A

Uncommon, reported in pigs and dogs

- nonregenerative anemia

100
Q

Folate and cobalmin (Vit B9 and B12)

A

Required for DNA synthesis so deficiencies lead to abnormal cell production

  • macrocytic anemia in people, rare in animals
  • macrocytic (or normocytic) normochromic, nonregenerative anemia with macrocytes
101
Q

Pyridoxine (Vit B6)

A

Reported dietary deficiency in kittens causing anemia

102
Q

Hypothyroidism

A

Dogs

  • decreased metabolic rate –> decreased oxygen need –> decrease EPO –> anemia
  • normocytic normochromic nonregenerative anemia
  • evidence of thyroid dysfunction
103
Q

Hypoadrenocorticism

A

Dogs

  • normocytic normochromic nonregenerative anemia
  • unknown
  • evidence of adrenal dysfunction (hyponatremia, hyperkalemia, hypocortisolemia, lymphocytosis, eosinophilia)
104
Q

Hyperestrogenism

A 
Excessive production (neoplasms: Sertoli cell tumor, granulosa cell tumor), or iatrogenic
- nonregenerative anemia (pancytopenia), especially in dogs and ferrets
105
Q

Liver disease/failure

A

Progressive normocytic normochromic (occasionally microcytic normochromic in dogs with hepatic insufficiency) nonregenerative anemia

  • AID
  • defective amino acids, protein and lipid metabolism affecting RBC membranes and life span
  • dogs: not total Fe deficiency, possibly functional Fe deficiency
106
Q

Hepatic dz - lab findings

A
  • normocytic (or microcytic) normochromic nonregenerative anemia
  • hypochromasia is rare
  • elevated liver enzymes
  • decreased BUN/hypoalbumenemia
  • prolonged clotting times
  • increased serum bile acids
  • hyperammonemia
107
Q

Blood loss anemia - causes

A
  • hemorrhage: blood vessel damage by trauma, acquired/congenital hemostatic impairment
  • parasitism
  • donating for blood transfusions
108
Q

Classification based on _______

A

Duration and location

109
Q

Acute blood loss anemia

A
  • sudden loss of blood from vessel –> hypovolemia
  • shift of ECF into vessels dilutes erythrocytes –> anemia
  • splenic contraction reduces severity of anemia
  • few hrs after blood loss
  • tissue hypoxia –> EPO prodcution –> reticulocytes in 3-4 days (horses)
110
Q

Blood loss in hemothorax or hemoperitoneum

A
  • 65% resorption in 2 days and 80% in 1-2 weeks

- no Fe depletion

111
Q

Acute blood loss anemia - clinical findings

A
  • observation of blood via gross external hemorrhage, hemothorax/peritoneum
  • regenerative anemia (after 3-4 days)
  • hypoproteinemia, hypoalbumenemia, hypoglobulenima (less severe if internal bleeding)
112
Q

Chronic blood loss anemia that leads to _______

A

Iron deficiency

  • compensatory erythropoiesis prevents anemia for weeks-months
  • Fe deficiency diminishes erythropoiesis and causes mild anemia
  • full blown Fe deficiency causes microcytic hypochromic anemia
113
Q

Fe depletion

A
  • maturation and release of RBCs are impaired
  • RBCs more fragile and deformable –> decreased life span
  • reticulocytosis is present, but less than expected (marrow is poorly responsive)
114
Q

Chronic blood loss - clinical findings

A
  • melena, hematuria, parasites
  • poorly or nonregenerative anemia
  • microcytic normochromic or hypochromic anemia
  • BM: erythroid hyperplasia but ineffective erythropoiesis
  • mild-moderate hypoproteinemia
  • hypoferremia, decreased total body Fe and decreased ferritin
  • young animals more prone due to small Fe store
115
Q

Increased rate of erythrocyte destruction

A

Hemolytic anemia

  • intravascular: occurs in heart, blood vessels –> hemoglobulinemia and hemoglobinuria
  • extravascular: occurs outside vessels, erythrocytes are phagocytized
116
Q

Why differentiate between intravascular and extravascular?

A
  • intravascular has a poorer prognosis
  • diseases may switch from one to the other, or cause both
  • examine blood smear
117
Q

What 3 things are caused by hemolytic anemia?

A
  • icterus
  • bilirubinuria
  • urobilinogenuria
118
Q

Hemolytic hemoglobinemia/hemoglobinuria

A
  • Hgb tetramers –> Hgb dimers –> bind to haptoglobin –> hepatocytes –> unconjugated to conjugated bilirubin+Fe
  • secondary: bind to hemopexin instead
  • overflow: Hgb dimers –> glomerular filtration –> hemoglobinuria
119
Q

IMHA not associated to infection

A

Animal produces Ig that binds to RBC surface (erythrocyte surface associated immunoglobulin)

  • ESAIg could be IgM/G/A
  • if Ig fix complement MAC –> hemolysis
  • Coombs test to detect ESAIg or complement on RBCs
120
Q

Idiopathic hemolytic anemia clinical findings

A
  • regenerative anemia (mild-severe)
  • icterus
  • possible hemoglobinuria
  • spherocytosis
  • positive Coombs or flow cytometry
  • acute inflammatory leukogram
  • lack findings of other IMHAs
121
Q

Drug induced hemolytic anemia

A
  • penicillin: horses
  • propylthiouracil: cats
  • cephalosporins: supraphamacological doses in dogs
  • TMS: horses
  • levamisole: dogs
  • pirimicarb: dogs
122
Q

Vaccine-induced hemolytic anemia occurs mostly in _______

A

Dogs

123
Q

Alloimmune hemolysis

A

Neonatal isoerythrolysis

- colostral Ig –> intestinal absorption –> bind to RBCs paternally inherited antigens

124
Q

Incompatible drug transfusion

A

Donor’s erythrocytes attacked by recipient’s antibodies

  • alloantibodies are the same of neonatal isoerythrolysis
  • dogs and horses: acquired (pregnancy or transfusions)
  • cats: natural
125
Q

Feline hemic microplasma spp.

A

Causes feline infectious hemolytic anemia

  • M. hemofelix: more pathogenic, larger
  • candidatus M. haemominutum: opportunistic
  • parasitemia is present during hemolysis (may disappear fast)
  • may detach from RBCs, so review fresh blood smears
126
Q

Canine hemic mycoplasma spp

A

M. haemocanis: splenectomized or immunologically compromised dogs
- may detach from RBCs

127
Q

Hemothropic mycoplasma spp - lab findings

A

Mycoplasma on erythrocytes (surface) –> most numerous when Hct is falling

  • moderate-severe anemia
  • reticulocytosis/polychromasia
  • hyperbilirubinemia/hyperbilirubinuria
  • positive Coomb’s test
  • spherocytosis
  • autoagglutination
  • PCR positive for mycoplasma
128
Q

Anaplasma spp

A

Immune mediated

  • moderate-severe anemia
  • reticulocytosis/polychromasia
  • mild-marked hyperbilirubinemia/hyperbilirubinuria
129
Q

Does Leptospira interrogans infect RBCs?

A

No

- vasiculitis, infection of liver and kidneys –> hemolytic state

130
Q

Leptospira - lab findings

A
  • moderate-severe anemia
  • hemoglobinemia/hemoglobinuria
  • hyperbilirubinemia/uria
  • neutrophilia
  • leptospiral in urine
  • IgM cold agglutinins
131
Q

Clostridium

A

Haemoliticum and C. novyii type D

  • cattle and sheep: bacillary hemoglobinuria
  • beta-toxin with phospholipase and lecithinase activity
  • severe anemia
  • hemoglobinemia/uria
  • postmortem diagnosis
132
Q

Clostridium

A

Type A

  • yellow lamb disease
  • alpha-toxin with phosphlipase C activity
  • acute severe: anemia, hemoglobinemia/uria
  • less severe: anemia, polychromasia, reticulocytosis, rubricytosis, leukocytosis
133
Q

Equine infectious anemia virus

A

Retrovirus that infects cells from mononuclear phagocytic system in horses, mules, donkeys, ponies

  • production of TNF and cytokines –> decrease RBC production
  • hemolysis via immune complexes or complement on RBCs (extravascular)
134
Q

EIA lab findings

A
  • acute: intravascular hemolysis, hemoglobinemia
  • chronic: extravascular hemolysis
  • macrocytosis
  • thrombocytopenia
  • neutropenia/neutrophilia
  • positive Coomb’s test
135
Q

Babesia

A

Look at capillary blood or buffy coat preparation

  • nonhemolytic an dhemolytic processes
  • chronic: rare organisms in RBCs, mild anemia, mild lymphocytosis
  • acute: many organisms in rBCs, moderate-severe anemia, reticulocytosis, polychromasia, macrocytosis
136
Q

Theileria buffeli

A

Organisms in RBCs

  • macrocytosis
  • polychromasia
  • basophilic stippling
  • lymphocytosis
  • hyperbilirubinemia/bilirubinuria
137
Q

Heinz body hemolytic anemia

A

Oxidant exposure overwhelms reductive pathway

  • decreased RBC deformability –> trapped in spleen –> removed by macrophages
  • fragile cells –> intravascular lysis
  • membrane associated protein change –> autologous antibodies recognition –> extravascular hemolysis
138
Q

Heinz body hemolytic anemia - lab findings

A
  • mild-severe anemia
  • reticulocytosis/polychromasia
  • eccentrocytosis
  • hyperbilirubinemia/uria
  • hemoglobinemia/uria
  • methemoglobinemia
139
Q

Feline Heinz bodies

A
  • spleen with closed circulation
  • feline Hgb is prone to form oxidized forms
  • feline erythrocytes have lower reductive ability
140
Q

Eccentrocytic hemolytic anemia

A

Eccentrocytes are more rigid/trapped and removed by macrophages in spleen –> more fragile and prone to lysis

  • acquired: oxidative insult can form eccentrocytes or Heinz bodies
  • inherited
141
Q

Hypophosphatemic hemolysis

A

Postparturient hemoglobinuria in cattle

  • decreased phosphate mobilization from bone, increased loss via milk production –> decreased phosphorous plasma concentration –> decreases ATP in RBCs = unstable RBC membranes and lysis
  • hypophosphatemia
  • hemoglobinemia/uria
  • moderate-marked anemia
142
Q

Hypoosmolar hemolysis

A

Rapid infusion of hypoosmolar fluids IV

  • water intoxication in calves
  • hypoosmolar plasma –> rapid movement of water into RBCs = swelling and lysis
  • anemia
  • hemoglobinemia/uria
143
Q

Trauma

A

Presence of rigid structures

  • erythrocyte trauma –> poikilocytes or lysis
  • mild to moderate anemia
  • possible reticuloytes/polychromasia
  • schistocytes
  • keratocytes
  • acanthocytes
  • thrombocytopenia
144
Q

Hemoconcentration due to dehydration

A

Most common cause of erythrocytosis in mammals

  • hyperproteinemia
  • hyperalbuminemia
  • hypernatremia and hypercholremia
145
Q

Hemoconcentration due to endotoxic shock

A

Shift of water from intravascular to extravascular

  • enothelial cell damage –> increased permeability –> decreased oncotic pressure –> plasma migrates from intra to extravascular
  • mild to moderate erythrocytosis
  • inflammatory leukogram
  • thrombocytopenia
146
Q

Physiologic erythrocytosis

A

Splenic contraction, common in dogs and horses

  • physical excitement –> epinephrine –> splenic contraction –> shift of RBCs from spleen to peripheral blood
  • mild to moderate transient erythrocytosis
147
Q

Secondary appropriate erythrocytosis

A

Erythropoiesis is stimulated by EPO and not autonomous

  • EPO is increased due to hypoxia
  • erythrocytosis caused by increased production (cardiac dz, pulmonary dz, hyperthyroidism)
  • high altitudes
  • prolonged training in horses
148
Q

Secondary appropriate erythrocytosis - pathogenesis

A

Hypoxemia –> sustained renal tissue hypoxia –> increased EPO production –> increased reythropoiesis –> erythrocytosis

149
Q

Secondary inappropriate erythrocytosis

A

Inappropriate increased EPO production due to:

  • renal cysts
  • renal neoplasms
  • benign neoplasms (not renal)
150
Q

Primary erythrocytosis

A 
Autonomous eryhtropoiesis (not dependent on EPO)
- mild to marked erythrocytosis --> increased viscosity of blood --> poor tissue perfusion --> secondary increased EPO production
151
Q

Primary erythrocytosis

A

Neoplastic or non-neoplastic dz that leads to increased RBC production independent of EPO

152
Q

Polycythemia vera

A

Neoplastic dz of erythroid, myeloid and megakaryocytic cell lines

Clinical Pathology (9 decks)

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