Haemotology- In Systemic Disease

Question 1

What are 3 contributors in anaemia of chronic disease?

Answer 1

Iron dysregulation: available iron isn’t released for use in bone marrow. The marrow shows a lack of response to erythropoietin. There is reduced lifespan of red cells.

Question 2

Role of hepcidin and what is regulated by?

Answer 2

It degrades ferroportin, preventing iron release from macrophages and preventing iron absorption from gut. It’s regulated by HFE and transferrin receptor.

Question 3

Treatment of anaemia of chronic disease.

Answer 3

Ensure vitamin B12, folate and iron stores are adequate. Transfuse red cells, but only if all else fails and the patient is symptomatic.

Question 4

Treatment of rheumatoid arthritis.

Answer 4

Pain relief (often NSAIDs), disease modifying agents e.g. corticosteroids.

Question 5

How does chronic liver disease lead to anaemia?

Answer 5

Causes portal hypertension which causes splenomegaly, leading to: splenic sequestration of cells, overactive removal of cells -> therefore low blood counts.

Question 6

Why are target cells often seen in liver disease?

Answer 6

Due to an increased cholesterol:phospholipid

Question 7

What’s seen in leucoerythroblastic film?

Answer 7

Granulocyte precursors and nucleated RBC seen on blood film.