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Anemia

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Published in: Biology
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Classification of Anemia 

Mohit K / Varanasi

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Qualification: M.Sc(biotechnology),from BHU

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  1. Classification of Anemia (Adults) SUBM IT TED BY: MOHIT KUMAR
  2. Definition of anemia ' Anemia: A reduction in — red cell mass — 02-carrying capacity ' It is expressed in terms of reduction in the concentration of Hb (or RBC or Hct%) compared to values obtained from a reference population. (2 SD below normal)
  3. Reticulocyte Normal Ranges Male: 0.8 - 2.5 Female: 0/00.8-4.1 Corrected Rtc: Patient Hb/Normal Hb x Rtc % Reticulocytosis: > 100.000 /mm3
  4. Definition of anemia Hb level of a patient which is below the normal ranges of that age and sex. For adults: WHO criteria define anemia as hemoglobin level lower than 12 g/dL in women and 13 g/dL in men But: The reference values for red cells ,Hb or Hct may difer according to sex/age Race Altitude Socioeconomical changes Study/reference etc
  5. age 12 mo 10y 21 y Age and bl ood count changs 1- WBC 6-17.5 5.5-15 5-14.5 45 4.5-11 Neutrophyls EOS. 1.585 1.5 8.5 1.58 1.88 1.8 7.7 0.05-0.7 0.02- 0.65 0-0.65 0-0.60 0-0.45 Hb:g/dL Baso 0-0.20 0-0.20 0-0.20 0-0.20 0-0.20 Lenfo 4-10.5 2-8 1 .5-7 I .5-6.5 4.8 M ono 0.05-1.1 0-0.8 0-0.8 0-0.8 0-0.8 11.1-14.1 11.2-14.3 11.4—14.5 11.8-15 E: 16 K : 14 WBC: xl OE3/mm3
  6. Anemia leads to two symptom complexes; Tissue hypoxia — Fatigue,dyspnea on exertion etc ' Compensatory attempts — Tachycardia,hyperventilation etc
  7. ' The amount of 02 necessary to support life is : 250 ml/min 0 02 carrying capacity of normal blood:1.34 ml/g- Hb (200 ml/L-blood) ' Cardiac output: 5000 ml/min 0 02 delivery to tissues : 1000 ml/min
  8. ' Reduced levels of Hb results with reduced oxygen delivery to tissues , leading to tissue hypoxia. The symptoms and findings of anemia concern many different systems/organs due to the widespread nature of hypoxia.
  9. The most pronounced effects and symptoms derive from — skeletal muscles, heart,and central nervous system (due to their greater oxygen demand and compensatory actions). What is the mechanism underlying compensatory mechanisms ?
  10. Clinical symptoms and findings of anemia (1) The symptoms and findings are related to anemia itself or to the underlying disease that causes anemia . The symptoms and findings related to anemia itself will be mentioned during this course.
  11. Clinical symptoms and findings of anemia (2) ' Fatigue, weakness — Tiredness, lassitude, reduced exercise tolerence — Generalized muscular weakness ' Pallor /skin or mucous membranes — Skin color may change due to other reasons; eg :BIood flow of skin, subcutaneous fluid , pigment changes
  12. Pallor (paleness): Look at Mucous membranes of mouth and pharynx Conjunctivae,lips, nail beds,palms Hb < 7g/dL Creases of the palms lose their pink colour when the In pernicious anemia there is a lemon yellow pallor. Pallor + mild scleral icterus suggests hemolytic anemia. Pallor+ petechiae suggests severe bone marrow failure
  13. Some other skin/mucosal changes Premature graying of hair:pern.anemia Hair loss and fragility + spooning of the nails:iron deficiency Chronic leg ulcers:SickIe cell or other hemolytic anemia o Glossitis/burning sense :Pern. anemia, iron deficiency(rare) Chelitis(angular stomatitis):iron def. Siideropenic dysphagia: iron def. o Painful ulcerative mouth lesions: aplastic anemia/leukemia
  14. Classification of anemia ' Morphologic — Normocytic: MCV= 80-100fL — Macrocytic: MCV > 100 fL — Microcytic : MCV < 80 fL ' Pathogenic (underlying mechanism) — Blood loss (bleeding) — Decreased RBC production — Increased RBC destruction/pooling
  15. Microcytic anemias ' Iron deficiency anemia Thalassemia Sideroblastic anemia Lead poisoning ' Anemia of chronic diseases (some cases)
  16. Macrocytic anemias Megaloblastic Non-megaloblastic
  17. Megaloblastic Macrocytic Anemias Vit B12 deficiency ' Folic acid deficiency Other.
  18. Pathogenic classification (Causes of anemia) Rd ative (i ncreased pl asma vol ume) Decreased RBC production Blood loss — Anemia due to acute bleeding Increased RBC destruction
  19. Pathogenic classification (Causes of anemia) Decreased RBC production — Decreased Hb production — Defective DNA synthesis — Stem cell defects • Pluripotent stem cell • Erythroid stem cell(progenitors) — Other less defined reasons • Blood loss — Anemia due to acute bleeding Increased RBC destruction Relative(increased plasma volume)
  20. Decreased Hb production ' Iron deficiency anemia Thalassemia Sideroblastic anemia Lead poisoning
  21. Defective DNA synthesis Vit B12 deficiency ' Folic acid deficiency Other.
  22. Pluripotent stem cell defects Aplastic anemia ' Leukemia or myelodysplastic syndromes Defective erythroid stem cell Pure red cell aplasia Anemia of chronic renal failure Endocrin disease anemia Congenital dyserythropoetic anemias
  23. Decreased RBC production due to multipl or undefined mechanisms Anemia of chronic diseases Bone marrow infiltration Anemia due to nutritional defects
  24. Anemias caused by increased RBC destruction (hemolytic anemias) Can be classified as; ' Hemolysis due to intracorpuscular defects ' Hemolysis due to extracorpuscular defects Or ' Hereditary hemolytic diseases Acquired hem. diseases Or ' Intravascular hemolysis ' Extravascular hemolysis etc.
  25. THANKS O

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