Regenerative anemia Flashcards
Acute blood loss types
External hemorrhage
Internal hemorrhage
External hemorrhage
Any type of bleeding where the blood is not resorbed
Protein and iron are lost
Internal hemorrhage
Into a body cavity or deep tissues. Sme RBC can be resorbed and re-enter circulation or phagocytosis by tissue macrophages to increase serum bilirubin
Acute blood loss
Blood loss-> hypovolemia-> hemodilution-> anemia
Persistent small volume blood loss
Can lead to iron deficiency and will be regenerative initially but over time will become non-regenerative, usually still see a degree of polychromasia
Intravascular hemolysis
Rupture in vascular system causes free Hgb (hemoglobinemia and hemoglobinuria)
Extravascular hemolysis
Intracellular (macrophages) usually in spleen
Prehepatic hyperbilirubinemia
Icterus due to increased Bu production due to hemolytic disorders. Liver cant keep up with production
Pathogenesis of IMHA
RBCs coated with ESAIg undergo extravascular hemolysis in macrophages and are turned into spherocytes these then go undergo extravascular or intravascular hemolysis because of rigidity and fragility
Common findings with IMHA
-Low Hct, RBC and Hgb
-Almost always has positive RBC surface associated immunoglobulin, regeneration, and inflammatory leukogram
Coomb’s test
Detects antibody or complement bound to the RBC surface. Was RBC with saline and incubate with anti-antibodies and add coomb’s reagent and look for agglutination
Hemolytic anemia due to oxidative damage causes
-Onions, leeks, garlic, chives
-Acetaminophen
-Zinc
-Diabetes mellitus
-Wilted red maple leaves (horses, ponies, llamas)
-Copper (sheep)
Organisms that can cause hemolytic anemia
-Mycoplasma haemofelis/hemocanis/wenyonii/ haemosuis (extracellular)
-Anaplasma marginale(intracellular)
-Babesia/Theileria
RBC fragmentation
Creates schistocytes caused by fibrin in small vessels or severely turbulent blood flow. Doesnt generally cause severe hemolytic anemia, but a bad underlying problem and may be regenerative or non-regenerative
Anemia from decreased ATP
Hypophosphatemia induced hemolysis, erythrocyte glycolysis is inhibited so there is less erythrocyte ATP concentration and subsequent hemolysis