Thalassemia Flashcards
Alpha thalassemia trait blood film
Mild microcytic anaemia
Target cells
RARE- basophilic stippling
Differential diagnosis with alpha thalassemia trait
IDA or a comordity with this
Other types of Thalassaemia
ACD
lead poisoning
Further tests for Thalassaemia
Hb electrophoresis (acid and alkaline)
PCR
Patient history - genetic counseling
FBC
HPLC
Thalassaemia vs IDA with RBC and MCV
Thalassaemia - marked decrease in MCV and RBC is increased
IDA- MCV is decreased. RBC is normal or decreased
Hbh disease blood film
Marked microcytosis hypochromic
Poikilocytosis
Target cells
Polychromasia
Bite cells
Further tests for HbH disease
PCR
Incubated reticulocyte stain to look for Hbh bodies
ICT
Hb electrophoresis
Differential diagnosis for Hbh disease
Alpha Thalassaemia minor
What are the reticulocytes like in Hbh disease
Increased
What do the Hbh bodies look like
Golf ball inclusions
More symmetrical distribution of clumping than reticulocytes and more spread through the cell
What are Hbh bodies made of
Beta 4 complexes
What type of stain is the incubated reticulocyte stain
A supra vital stain
Beta Thalassaemia trait blood film
Mild microcytosis hypochromic
Target cells
Basophilic stippling
Elliptocytes
Poikilocytosis
Platelets in beta Thalassaemia trait/minor
Thrombocytosis
Beta Thalassaemia intermedia blood film
NRBCs
Target cells
Poikilocytosis
Polychromasia
Basophilic stippling
Tear drops
Elliptocytes
Platelets in beta Thalassaemia intermedia
Marked Thrombocytosis
differential diagnosis for beta Thalassaemia intermedia
Beta Thalassaemia major
Treatment for severe beta Thalassaemia intermedia
Blood transfusions
Splenectomy
Beta Thalassaemia major blood film
Marked microcytic hypochromic anaemia
Poikilocytosis, anisocytosis
TARGET CELLS
Tear drops
Elliptocytes
Fragments
Microspherocytes
Erythroblasts
Basophilic stippling
Alpha chain inclusion bodies
Haemolysis and erythroid hyperplasia
Sickle cell blood film
Chronic haemolytic anaemia/normochromic normocytic anaemia
Anisocytosis, polychromisa
Some normal RBC
Targets cells
Sickle cells
Poikilocytosis
Reticulocytes in HbS
Increased unless aplastic
Infarcted spleen blood film
Marked poikilocytosis
NRBCS
Pappenheimer bodies
Howell jolly Bodies
Spherocytes
Basophilic stippling
Differential diagnosis for HbS
HbS with another haemoglobinopathy like HbSC
Beta Thalassaemia + sickle cell
Further tests for HbS
Screening tests - solubility tests, sickling tests
Hb electrophoresis (alkaline and acid)
PCR
Family history
Ethnicities - greater in Africa
HbE blood film
VERY small MCV (50-70)
Marked microcytic anaemia
TARGET cells
Anisocytosis
Further tests for HbE
Same as HbS
Differential diagnosis for HbE
Thalassemia
IDA
Platelets and WBC in HbS
Both increased
HbC blood film
Normocytic normochromic anaemia
Sometimes microcytic hypochromic
Target cells
Reticulocytosis
Could have NRBC
Target cells are seen in
Thalassaemia
HbS
Liver disease
Post splenectomy
