haematology: common causes of anemia Flashcards
What population is at risk for iron deficiency anemia
Preschool children
Women in reproduction period
Pregnant women
Developing countries (food insecurity)
What is the 4 causes of iron deficiency with example
- Dietary insufficiency: vegan/vegetarian diet, elderly & low SES
- Increased demands: growing children, premenopausal & pregnant women
- Impaired absoprtion: Celiac disease/IBD, H. pylori & GIT surgery
- Chronic blood loss: GIT (peptic ulcers, carcinoma) UT (tumors) GT (post partum, cancer)
What does megaloblastic anemia lead to
Defective DNA synthesis
What cells can become affected in advanced megaloblastic anemia
Platelets & neutrophils can also be affected
What is the 2 causes of megaloblastic anemia with example
- Impaired absorption: pernicious anemia, defects of intrinsic factors, total/partial gastrectomy & theft (tapeworm or infection)
- Insufficient intake: inadequate diet
What is pernicious anemia
Autoimmune disorder
Immune mediated atrophy of parietal cells leading to decreased production of intrinsic factor
What population group is at risk for pernicious anemia
Female, blue eyes, vitiligo, premature greying, blood group A & northern Europeans
At what are people with pernicious anemia at risk of
GI cancer
What is the diagnosis for pernicious anemia
Test for intrinsic factor & parietal cell autoantibodies
What is the 5 causes of folate deficiency with example
- Dietary insufficiency: old of age, alcoholism, poverty
- Impaired absorption: surgery, gluten induced enteropathy
- Increased loss: active liver disease or heart failure
- Increased demand: pregnancy & lactation, cancer or choric hemolysis
- Drugs: anticonvulsants & folic acid antagonist
Clinical features of folate deficiency
Glossitis & angular stomatitis
Mildly jaundiced
Neuropathy
NTD
Hypersegmented neutrophils & oval macrophages
What is anemia of inflammation/chronic disease
Mild to moderate anemia that develops in the context of systemic inflammation
What population group is at risk of developing anemia of chronic disease
Chronically ill patients
What is the pathophysiology of anemia of chronic disease
Inflammtory stimulus causing release of inflammatory cells
1. Hepcidin caused iron restriction that results in decrease iron release
2. Decreased RBC survival due to increase erythrophagocytosis & decreased erythrocyte lifespan
3. Erythroid suppression due to increased myeloid cells due to inflammatory response & decrease erythroid precursor
What is hepcidin’s 3 functions
- Impairs iron absorption in GIT
- Inhibits storage iron release from macrophages
- Accelerating degradation of ferroportin
