L 4 hematology

Anemia
Anemia is a global public health problem affecting both developing and developed
countries at all ages. According to the World Health Organization (WHO), anemia
is defined as hemoglobin (Hb) levels <12.0 g/dL in women and <13.0 g/dL in men

classification Of Anemia
Etiological classification:
I. Blood loss: acute OR chronic
II. Impaired production(hypo prolifrative)
• Disturbance of proliferation and differentiation of stem cells
• Disturbance of maturation of erythroblasts
III. Increased Destruction (Hemolytic Anemias)
• Extrinsic to red blood cells (auto immune , infections, physical or
chemical agents)
• Intrinsic to red blood cells (membrane defect, enzyme deficiency,
hemoblobinopathy)
Morphological classification:
I. Normochromic normocytic anemia
II. Microcytic hypochromic anemia
III. Macrocytic anemia

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Iron Deficiency Anemia
Iron Losses
• Iron is closely conserved in humans
<0.05% of iron is lost per day normally
1. Very small amounts in urine, bile and sweat
2. Cells shed from skin, intestinal and urinary tracts
3. Menstrual blood loss
4. Pregnancy and lactation
• Humans have NO other physiologic means to excrete excess iron
Pathogenesis of Iron Deficiency
 Blood loss
o Occult or overt GI losses, traumatic or surgical losses
 Failure to meet increased requirements
o Rapid growth in infancy and adolescence
o Menstruation, pregnancy
 Inadequate iron absorption
o Diet low in heme iron
o Gastrointestinal disease or surgery
o Excessive cow’s milk intake in infants

Features of Iron Deficiency Anemia

 Depends on the degree and the rate of development of anemia
 Symptoms common to all anemias:
pallor, fatigability, weakness, dizziness, irritability

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Tests for Iron Deficiency
• Peripheral blood smear
• Red cell indices (MCV, MCH)
• Serum ferritin
• Serum iron / transferrin = iron saturation
• Bone marrow iron stain (Prussian blue)

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