L2 Non-Regenerative Anaemia

Question 1

Are reticulocytes present in non reg anaemia?

Answer 1

Can have SOME but will be within reference range. Non reg anaemia is anaemia without RETICULOCYTOSIS

Question 2

What two broad causative groups do we use to deduce causes for non regen anaemia?

Answer 2

either REDUCED or DEFECTIVE erythropoiesis

Question 3

Describe reduced erythropoiesis in super detail lol

Answer 3

• Generally mild and symptoms relate to Dz not anaemia
  
  • Anaemia of inflammatory or chronic Dz –> inflammation –> dec EPO production* (due to sequestration of iron to stop bacteria using it, energy into making other cells) –> **immune mediated destruction of precursors (iron) –> decreased erythrocyte survival
  • Marrow disease, infectious disease
    
    • Lymphoma (myelophthisis), fibrosis (myelofibrosis), myeloproliferative Dz e.g. leukaemia, marrow toxicity e.g. brakenfern, phenylbutazone
    • FeLV, Anaplasma, Parvovirus
  • *Dec EPO= chronic renal disease or uraemia syndrome, endocrine disease (hypoandrenocorticism etc.)
  • ** IMHA, RBC aplasia, response to corticosteroids/ lymphcytotoxic drugs
    
    • Will present as normocytic normochromic mild to moderate anaemia (Hct 20-30%) that is fairly stable. Also dec serum iron and evidence of inflammation or chronic Dz. **diagnosis of exclusion/ resumption

LOLOLOL

Question 4

what do the symptoms of reduced erythropoiesis usually relate to?

Answer 4

The underlying Dz process not the actual anaemia (generally mild)

Question 5

What are some diseases that can lead to non-regenerative anaemia??

Answer 5

lymphoma, fibrosis, myeloproliferative Dz e.g. leukaemia, toxicity e.g. bracken fern, phenylbutazone, FeLv, Anaplasma, Parvovirus

Question 6

relate decreased EPO to renal function

Answer 6

could be due to chronic renal Dz or due to more 2ary disease due to circulating uraemia

Question 7

What are the main mechanisms which leads to defecting EPO formation

Answer 7

Iron deficiency, Lead poisoning, B12/B6 deficiency, Copper deficiency, Marrow Dz, genetic/ metabolic disorders

Question 8

How does Iron deficiency lead to defective erythropoisisis

Answer 8

decrease haemoglobin synthesis causes inflammation as iron no longer protected by RBC. Hallmark will be microcytic hypochromic anaemia because Dec Hb means more cell division before RBC maturation. Small cells and fragmentation.

Question 9

How does lead poisoning lead to defecting erythropoiesis

Answer 9

• Inc nucleated RBC “Inappropriate Metarubricytosis” (innapropriate would be part of regenerative repsonse, but then there would be reticulocytosis) (meta and ruricytes), no reticulocytosis, basophilic stippling
  Generally will present seizing, chronic tox.

Question 10

Give some examples of genetic & metabolic disorders that lead to non-regenerative anaemia

Answer 10

• Asian dog breeds have normal microcytosis but normal Hb so not hypochromic (Shar Pei, Chow chow)
• Miniature poodles have normal macrocytosis
• Cobalamin deficiency in Border Collies (poor nucleic acid synth)

Question 11

What diagnostic modalities would you use to investigate a suspected non-regenerative anaemia

Answer 11

CBC –> for degree of anaemia
MCV, MCHC, RDW –> check everything is within indices
Smear –> evidence of regeneration, morphology

+ history & clinical signs

For progressive, persistent non regenerative anaemia, bone marrow evaluation

Question 12

The opposite of anaemia is…

Answer 12

Erythrocytosis

Question 13

How is erythrocytosis reflected in blood tests?

Answer 13

inc RBC –> HCT, PCV, RBC, Hb