Iron deficiency anemia is the most common type of anemia. It occurs when there is inadequate iron intake or absorption to support normal red blood cell production. Symptoms include pale skin, brittle nails, and fatigue. Treatment involves finding and treating the underlying cause, oral iron supplementation, or intravenous iron for more severe cases.
Megaloblastic anemias are caused by vitamin B12 or folate deficiencies interfering with DNA synthesis. Features include pale skin, neurological changes, and macrocytic red blood cells. Treatment involves vitamin B12 injections or high dose oral folate supplementation.
Anemia of chronic disease is seen in conditions like infections, inflammation, and cancer. It is caused by reduced iron availability
Iron deficiency anemia is the most common type of anemia. It occurs when there is inadequate iron intake or absorption to support normal red blood cell production. Symptoms include pale skin, brittle nails, and fatigue. Treatment involves finding and treating the underlying cause, oral iron supplementation, or intravenous iron for more severe cases.
Megaloblastic anemias are caused by vitamin B12 or folate deficiencies interfering with DNA synthesis. Features include pale skin, neurological changes, and macrocytic red blood cells. Treatment involves vitamin B12 injections or high dose oral folate supplementation.
Anemia of chronic disease is seen in conditions like infections, inflammation, and cancer. It is caused by reduced iron availability
Iron deficiency anemia is the most common type of anemia. It occurs when there is inadequate iron intake or absorption to support normal red blood cell production. Symptoms include pale skin, brittle nails, and fatigue. Treatment involves finding and treating the underlying cause, oral iron supplementation, or intravenous iron for more severe cases.
Megaloblastic anemias are caused by vitamin B12 or folate deficiencies interfering with DNA synthesis. Features include pale skin, neurological changes, and macrocytic red blood cells. Treatment involves vitamin B12 injections or high dose oral folate supplementation.
Anemia of chronic disease is seen in conditions like infections, inflammation, and cancer. It is caused by reduced iron availability
Iron deficiency Secondary to many diseases Occurs when there is inadequate iron for Clinical: - Find and treat the underlying anaemia - Limited capacity for ison haemoglobin synthesis - Brittle hair cause absorption - Presence of depleted iron stores with or - Angular stomatitis - Oral iron - Loss of iron without functional or health impairment - Glossitis - Paraenteral iron - Inadequate dietary intake Causes: - Atrophy of tongue papillae - Increased demand: bleeding, growth - Brittle nails pregnancy - Koilonychia - Reduced supply: dietary insufficiency, - Pica malabsorption Lab results: Hb MCV MCH - Poikilocytosis RBC of varying shape - Anisocytosis RBS of varying sizes Serum iron Total iron binding capacity (TIBC) Serum ferritin Megaloblastic - Congenital enzymes deficiencies in DNA Lab results: anaemia synthesis Hb - Drugs interfering in DNA synthesis MCV - Myelodysplasia due to dyserythropoiesis - Leucopenia and thrombocytopenia (in severe cases) - Oval macrocytes, anisocytosis, poikilocytosis - hypersegmented polymorphonuclears (immature WBCs) Vitamin B12 B12 deficiency or its normal Normal function: Clinical features: - Initial: hydroxocobalamin metabolism - Intrinsic factor: transports B12 to ileum - Gradual and progressive 1mg IM per week x 3 doses - Transcolbamin II: transports in blood to - Lemon yellow colour - Maintenance: bone marrow - Glossitis and angular Hydroxycobalamin 1mg IM Factors compromising B12: stomatitis every 3 months - Vegan diet - Neurological changes - Oral preparations: - Gastrectomy - Peripheral polyneuropathy - 2mg tablet - Small intestine pathology and can lead to paraplegia - 2 x 1mg tablet sublingual - Drugs for gastritis, e.g. proton pump (due to defective methylation inhibitors of myelin) - Dementia - Psychological disturbances Vitamin B9 B9 deficiency or its normal Can be caused by: - Same as B12 clinically but - Treat the underlying cause metabolism - Alcoholism will not manifest neuropathy - Folate 5mg tablet oral x 4 - Anorexia - Neural tube defects (NTD) in months - Pregnancy newborn Prophylaxis: - Old age - Normal pregnancy: 400g daily throughout pregnancy - With previous child with NTD: 5mg daily throughout pregnancy - Also given in severe haemolytic anaemias and patients on chronic dialysis Anaemia of Related to causative disease: - Defective release of iron from storage - Blood film: normocytic -Treat the underlying cause chronic disease pulmonary TB, chronic (high level of hepcidin > decrease iron normochromic (can progress - EPO injections inflammatory disease, release from macrophage) to microcytic hypochromic) - Non-responsive to iron malignancy - Reduced RBC lifespan - Serum iron and Total iron supplementation - Inadequate EPO response (due to effect binding capacity (TIBC) of cytokines) reduced - Serum ferritin normal or raised Sideroblastic - Hereditary: X-linked - Defective haem synthesis (mutation in Detected through bone - Treat the underlying cause anaemia - Acquired ALA synthase) marrow examination - Pyridoxine (B6) - Primary - Increase iron uptake > increase iron - Thiamine (B1) (myelodysplastic, refractory deposition - EPO type) - Blood transfusions - Secondary (drugs, alcoholism, lead poisoning malignancy) Sickle cell - Autosomal recessive Results from a mutation in the globin - Vaso-occlusive crisis Preventing precipitating anaemia - Common is Africa, Middle chain - Anaemia: Hb, sickling of factors (infection, acidosis, (Hb abnormality) east and India Clinical subtypes: RBC, sickle solubility test, Hb dehydration, cold and - Hb SS sickle cell anaemia electrophoresis hypoxia) is the best course of - Hb SC sickle cell disease (Mild anaemia confirmatory management but higher incidence of retinal - Splenic sequestration: Hb, abnormalities) abdominal pain, splenomegaly - Hb AS sickle cell trait (no anaemia, - Bone marrow aplasia: Hb, normal blood picture, hematuria) reticulocytes
Hb S exposed to hypoxia > polymerization and crystallisation of Hb > sickling of RBC > loss of membrane flexibility > rapid degradation of RBC and blockage of microcirculation > blood stasis > tissue infarction Thalassaemia (Hb Abnormality)
Autosomal recessive disorder Thalassaemia Mediterranean region (excess globin formation) Caused by point mutations Thalassaemia major Homozygous - Failure to thrive, recurrent bacterial - RBC Management: infection - MCV - Folic acid supplements - Severe anaemia - Hb - Regular blood transfusions - Extramedullary haemopoiesis (liver, - Microcytic hypochromic - Bone marrow transplant spleen and other bones) anaemia - Gene therapy - Genetic counselling Thalassaemia - Becomes symptomatic in adolescence May have bone deformities Does not require blood intermedia - Presents with mild anaemia and splenomegaly transfusion - Still may be iron overloaded Thalassaemia minor Heterozygous Carrier state Usually asymptomatic (trait) Anaemia is mild or absent
Thalassaemia Far east region (excess globin formation) Caused by gene deletions 4-gene deletions No chain synthesised, only gamma Death in utero or shortly after chains > Hb Barts () instead of Hb F birth - Non-functional Hb
3-gene deletions Also known as Hb H (4) disease - Moderate anaemia Regular transfusion not need - Splenomegaly - Microcytosis 2-gene deletions Also know as - thalassaemia trait May or may not have anaemia - Microcytosis - Asymptomatic - Normal electrophoresis 1-gene deletion Also know as - thalassaemia trait - Asymptomatic - Clinical picture: normal - Blood picture: normal
Fast Facts: Deficiencia de piruvato quinasa para pacientes y familiares: Una enfermedad genética rara que afecta a los glóbulos rojos Información + Asumir el control = El mejor resultado