Non-Regen Anemia Flashcards
What causes a non-regen anemia?
decreased RBC production
Defective RBC proliferation
What causes rpimary non-regen anemia?
intramarrow dz
damage to BM
inadequate pdx of stem cells/progenitors
damage to the micro environment
What causes secondary non-regen anemia?
decreased nutrients
iron, copper folate, cobalamin
altered factors affecting erythropoiesis
decreased EPO/CSFs
increased pro-inflammatory cytokines
Is non-regen anemia selective? how so?
Can be
can affect only RBC production
pure red cell aplasia
OR not
affects all lineages
aplastic anemia
What are the classical signs of non-regen anemia?
classically normocytic, normochromic
NO RETICS
abnormal RBC morph
What are the abnormal RBC morphs you expect to see in non-regen anemia?
inapropriate rubricytosis
dysmaturation
what is the most common non-regen anemia?
Anemia of inflammatory disease
what causes AID?
chronic disorder w/ inflammatory component
chronic infection
bacT, fungla, viral protozoa
immune mediated
neoplasia
What cytokines are involved w/ AID
IL-1
IFN
Il-6
TNF-alpha
What are the affects of AID?
shortened RBC survival
Impaired iron mobilization/utilization
impaired RBC pdx
How does AID shorten RBC lifespan?
invovles IL-1
oxidant damage to RBD
IG binding
accelerated removal by spleen
How is AID involved in iron mobilization?
Hepcidin produced in response to IL6
binds iron channels
blocks iron export from macrophage
iron sequestration
How does AID impair RBC pdx?
IL1, 6, TNF reduce RBC precursor response to EPO
also reduce overall EPO response to anemia
Laboratory findings that support AID diagnosis:
MIld to moderate anemia
chronic inflammatory leukogram
hyperproteinemia
hypoferremia, serum ferritin increased
WHat are the clinical findings of CRF anemia?
mild to mod anemia
normocytic, normochromic
concurrent findings:
azotemia
isothenuria
electrolyte disturbance
