MORPHOLOGIC CLASSIFICATION OF ANEMIA Flashcards
presence of abnormal erythroblast in BM w/ delayed maturation
MEGALOBLASTIC ANEMIA
Macrocytic normochromic anemia
MCV
MCHC
MCV is >96 fL;
MCHC is NORMAL
Causes of Megaloblastic Anemia (5)
- Vitamin B12 deficiency – pernicious anemia
- Folic Acid Deficiency – Nutritional Megaloblastic Anemia
- Abnormalities of Vit B12 or folate metabolism
- Inherited disorders of DNA synthesis
- Drug-induced disorders of DNA synthesis
pernicious anemia
Vitamin B12 deficiency
Nutritional Megaloblastic Anemia
Folic Acid Deficiency
Macrocytic normochromic anemia Laboratory Findings
- Red cells are macrocytic – MCV is >95 fL and often as high as 120-140 fL (Normal: 80-96 fL)
- Macrocytes are typically oval shape
- Reticulocytes count is low in relation to the degree of anemia
- Total white cell count and platelet counts may be moderately reduced, especially in severely anemic patients
Macrocytic normochromic anemia peripheral smears (2)
- Normal RBC in morphology despite the:
–Drop of Hgb, Hct and RBC count - Increased bone marrow activity
–increased of Reticulocyte count)
–w/o increased red cell or hgb breakdown
shows macrocytic, normoblastic cells
NON-MEGALOBLASTIC ANEMIA
NON-MEGALOBLASTIC ANEMIA causes (6)
- Accelerated erythropoiesis
- Increased membrane surface area
–1 RBC = 23 Potassium - Obscure causes (hypoplastic & aplastic anemias)
- Alcohol
- Liver disease
- Cytotoxic drugs (e.g. metronidazole)
Small RBC size; Decreased Hemoglobin
Microcytic hypochromic anemia
Microcytic hypochromic anemia
MCV
MCHC
MCV is <80 fL
MCHC is <30%
Microcytic hypochromic anemia CAUSES (4)
- Iron deficiency (IDA)
- Disorder of globin synthesis as in thalassemia
- Disorders of porphyrin & heme synthesis as in sideroblastic anemia
- Other disorders of iron metabolism
Disorder of globin synthesis
thalassemia
Disorders of porphyrin & heme synthesis
sideroblastic anemia
Microcytic hypochromic anemia Peripheral Smear (4)
● Anisocytosis & Poikilocytosis
● Microcytic – since many are smaller than the nucleus of the lymphocyte
● Hypochromic – with increased central pallor
● Presence of elliptocytic & pencil-shaped forms