Microcytic Anaemia Flashcards
Define Microcytic Anaemia?
Anaemia associated with a low MCV (< 80 fl)
What are the causes of Microcytic Anaemia?
Iron Deficiency - Most Common
Anaemia of Chronic Disease
Thalassemia
Sideroblastic Anaemia
What are the causes of Iron Deficiency?
Blood Loss (e.g. GI) Reduced absorption (e.g. small bowel disease) Increased demands (e.g. growth, pregnancy) Reduced intake (e.g. vegans)
What is Anaemia of Chronic Disease?
Microcytic Anaemia in a patient with chronic disease
What is Sideroblastic Anaemia?
Abnormality of haem synthesis
It can be inherited or it can be secondary (e.g. to alcohol, drugs)
What is the epidemiology of Microcytic Anaemia?
Iron deficiency anaemia is the MOST COMMON form of anaemia worldwide
What are the symptoms of Microcytic Anaemia?
Non-Specific
Lead Poisoning Symptoms
What is the signficance of Lead Poisoning and Microcytic Anaemia?
Lead poisoning can cause Microcytic Anaemia
What are the Non-Specifc presenting symptoms of Microcytic Anaemia?
Tiredness Lethargy Malaise Dyspnoea Pallor Exacerbation of ischaemic conditions (e.g. angina, intermittent claudication)
What are the symptoms of Lead Poisoning?
Anorexia Nausea/vomiting Abdominal pain Constipation Peripheral nerve lesions
What are the signs of Microcytic Anaemia on physical examination?
Signs of Anaemia Glossitis Angular Stomatitis Signs of Thalassaemia Lead Poisoning Signs
What are the signs of anaemia for Microcytic Anaemia on physical examination?
Pallor
Brittle nails and hair
Kolionychia (if severe)
What are the Lead Poisoning Signs of Microcytic Anaemia?
Blue gumline Peripheral nerve lesions (causing wrist or foot drop) Encephalopathy Convulsions Reduced consiousness
What investigatiosn would you do for Microcytic Anaemia?
Bloods Blood Film Hb Electrophoresis Sideroblastic Anaemia Special investigations
What bloods do we do for Microcytic Anaemia?
FBC Serum Iron Total Iron Binding Capacity Serum Ferritin Serum lead
What do we look for specifcally on the FBC for Microcytic Anaemia?
Low Hb
Low MCV
Reticulocytes
What do we see with the serum iron for Microcytic Anaemia?
Low in iron deficiency
What do we see with Total Iron Binding Capacity for Microcytic Anaemia?
High in iron deficiency
What do we see on Serum Ferritin for Microcytic Anaemia?
Low in iron deficiency
What do we see on a Blood Film for Iron Deficiency Anaemia-related Microcytic Anaemia?
Microcytic
Hypochromic
Anisocytosis
Poikilocytosis
What do we see on a Blood Film for Sideroblastic Anaemia related Microcytic Anaemia?
Dimorphic Blood FIlm
Hypochromic Microcytic cells
What do we see on a blood film for Lead Poisoning related Microcytic Anaemia?
Basophilic stippling
Why do we do Hb Electrophoresis for Microcytic Anaemia?
Checking for Hb variants and thalassemia
What do we see for Sideroblastic Anaemia in the bone marrow ?
Ring sideroblasts
Who do we do special investigations for in Microcytic Anaemia and when are they considered?
For Iron Deficiency Anaemia if > 40 yrs and post-menopausal women
Considered if there is no obvious cause of blood loss identified
What special investigations do we do for this group of people in Microcytic Anaemia?
Upper GI Endoscopy
Colonoscopy
Haematuria
What is the management plan for Iron Deficiency-related Microcytic Anaemia?
Oral iron supplements
What is the management plan for Sideroblastic Anaemia-related Microcytic Anaemia?
Treat the cause
Pyridoxine used in inherited forms
Blood transfusion and iron chelation can be considered if there is no response to other treatments
What is the management plan for Lead Poisoning-related Microcytic Anaemia?
Remove the source
Dimercaprol
D-penicillinamine
What are the possible complications of Microcytic Anaemia?
High-output cardiax failure
Complications related to the CAUSE
What is the prognosis for patients with Microcytic Anaemia?
Depends on cause
