Haem: Haematology of Systemic Disease (Laz) Flashcards
List some ways in which lymphoma can cause jaundice.
- Direct liver involvement
- Compression of the bile duct
- Causing autoimmune haemolytic anaemia
Which types of anaemia can be cause by cancer?
- Iron deficiency
- Anaemia of chronic disease
- Haemolytic anaemia
- Leucoerythroblastic anaemia
Which types of cancer are associated with causing secondary polycythaemia?
- Renal cell carcinoma
- Liver cancer
- Due to the production of EPO
What is the most common cause of iron deficiency anaemia?
Occult blood loss (e.g. GI cancers, urinary tract cancers)
What are the typical laboratory findings of iron deficiency anaemia?
- Low ferritin
- Low transferrin saturation
- High TIBC
What is leucoerythroblastic anaemia?
Anaemia is characterised by the presence of red and white cell precursors
What are the morphological features of leucoerythroblastic anaemia seen on blood film?
- Tear drop red blood cells (aniso- and poikilocytosis)
- Nucleated RBCs
- Immature myeloid cells
What does leucoerythroblastic anaemia tend to be caused by?
- Bone marrow infiltration (leukaemia, lymphoma, myeloma, solid tumours, myelofibrosis, military TB, severe fungal infection)
Define haemolytic anaemia.
Anaemia caused by reduced red blood cell survival
List some key laboratory findings in haemolytic anaemia.
- Anaemia
- Raised reticulocytes
- Raised unconjugated bilirubin
- Raised LDH
- Low haptoglobins
NOTE: LDH is an intracellular enzyme that is released when RBCs are destroyed
What are the two main groups of haemolytic anaemia? List some examples.
Inherited (defects with the cell)
- Hereditary spherocytosis (membrane problem)
- G6PD deficiency (enzyme problem)
- Sickle cell disease, thalassemia (haemoglobin problem)
Acquired (defects with the environment)
- Immune-mediated
- Non-immune mediated
Which test distinguishes immune-mediated and non-immune mediated haemolytic anaemia?
DAT or Coombs’ test
DAT +ve means that the haemolytic anaemia is mediated through immune destruction of red cells
What morphological change is seen on the blood film of patients with autoimmune haemolytic anaemia?
Spherocytes
List some systemic diseases that can cause autoimmune haemolytic anaemia.
- Cancer involving the immune system (e.g. lymphoma)
- Disease of the immune system (e.g. SLE)
- Infections (disturbs the immune system)
List some causes of non-immune haemolytic anaemia.
- Infection (e.g. malaria)
- Microangiopathic haemolytic anaemia (MAHA)