haematological changes in systemic diseases Flashcards
what are the major causes of neutrophilia ?
bacterial infections inflammation/necrosis malignant disease drugs myeloproliferative disease
what does the presence of neutrophil precursors in the blood indicate ?
severe infections, e.g: bacterial pneumonia
severe haemorrhages or haemolysis
malignant disease
massive tissue damage-trauma, burns
what are leucoerythroblastic changes ?
the presence in the blood of nucleated RBC and immature WBC
what are the causes of leucoerythroblastic changes ?
1.marrow invasion :
metastatic tumor
haematological malignancies
2.severe illness:
trauma, septicaemia, massive haemolysis
what further investigation would a patient with leucoerythroblastic changes require ?
Bone Marrow aspirate and trephine biopsy
what are the causes of isolated neutropenia ?
Congenital Autoimmune Racial Drugs Post-viral malaria
what are main causes of esoniophilia ?
parasites allergies skin diseases malignancy inflammatory disease hypereosinophilic syndrome eosinophilic leukemia
what investigation are required with a patient presenting with eosinophilia ?
full travel and drug history
stool examination for parasites
may require stool examination for parasites
when can absolute lymphocytosis ?
acute infection
chronic infection
chronic lymphocytic leukemia
what are the most appropriate investigations with a patient that presents with lymphocytosis ?
history of viral illness
examination of throat and lymph nodes
viral serology
immunophenotyping or immunohistochemistry
what is infectious mononucleosis, and what is seen on its blood film ?
due to epstein barr virus , also called the kissing disease
atypical lymphocytes
what is pancytopenia ?
a reduction in the number of circulating blood cells
what causes a hypocellular marrow ?
cytotoxic therapy
aplastic anemia
what causes a hypercellular bone marrow ?
secondary cancers
haematological malignancies
myelodysplasia
what are the causes of aplastic anemia ?
congenital as with fanconi’s anemia
acquired aplastic anemia
autoimmune aplastic anemia
what is the managment for aplastic anemia ?
remove the causative agent supportive therapy ( transfusion) if its autoimmune appropriate immune suppressors ( cyclosporine) and anti-thymocyte globulin bone marrow transplantation
what does the prognosis of myelodysplastic syndrome depend on ?
number of cytopenia in the blood
number of blasts in the bone marrow
cytogenetics and chromosomal abnormalities
what is the management/treatment of myelodysplastic syndrome ?
cytotoxic chemotherapy
demethylating therapy
allogenic stem cell transplantation
supportive therapy
what is the Hb aim in patients suffering from bone marrow failure anemia ?
10 g/dl
what is the clinical management of leucopenia ?
non absorbable anti fungals
broad spectrum antibiotics
prophylactic acyclovir
what is the clinical presentation of thrombocytopenia ?
mucosal bleeding
purpura
retinal haemorrhages
what is the management of thrombocytopenia ?
if there is no bleeding then platelete infusion
usually require HLA matched platelets
what kind of anemia is associated with renal failure ?
normocytic anemia
what are the haematological changes in liver disease ?
bleeding tendency
why is there anemia in chronic renal failure ?
decreased erythropoietin production
increased hepcidin levels
anemia of chronic disease
how do we treat anemia in chronic renal failure ?
recombinant erythropoietin
