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Anemia DX TX
Anemia DX TX
ca)
Anemia ([Hgb] < 120g/L)
(Average MCV, CBC, and reticulocyte count assists with diagnosis!)
Iron deficiency
oral iron (high dose, low Low/normal
compliance) retics High retics High retics Low/normal Normal blood smear Abnormal blood
IM/IV iron (for low oral (polychromasia) retics remove offending drug smear
tolerance, permanent iron Dysplastic (i.e.
malabsorption) Anemia of CD Myelodysplasia)
treat underlying disorder
Splenomegaly/
Erythropoiesis-stimulating agents (ESAs): Folate Deficiency
Hypersplenism RBCs in Rouleaux
EPO, darbepoietin oral supplement
Thalassemia treat underlying Infiltrative (acute formation (stacked like
transfusion (rarely needed) rarely parenternal
Dx: Ethnicity, family Hx, blood spleen issue leukemia) chips – multiple myeloma)
smear (HbH bodies), HPLC, Hgb chemo/
electrophoresis hormonal cancer tx Aplastic anemia
stop causative agents & Target cells, normal WBCs
supplement B12/Folate. fix liver disease
HbE
Suppress T-Cells w/
Antithymocyte Globulin,
β-thalassemia
α-thal trait steroids, cyclosporin B12-deficiency
seen only after 6 mon Normal RBCs: RBC spherocytes/ Sickle-cell Anemia (HbSS):
No Tx Stem cell transplant
of life (after γ-globins Acute bleed, schistocytes: Sx: 1) vaso-occlusion of supportive care IF-treatment
stop being made) HbH disease AutoImmune or spleen, hands/feet, liver,
hemolysis (transfuse, antibiotics, etc)
High HbA2, HbF No Tx For pernicious
Hereditary brain, bones...; 2) hemolysis
anemia
spherocytosis – RBCs abnormal; 1+2 3) Not corrected w/ IF
Microangiopathic end-organ damage
β-thal major hemolytic anemia Dx: HPLC, Hgb
β-thal (MAHA) electrophoresis IM B12 injections Oral B12 (high dose,
smear: target cells, Minor Tx: prevent infection w/ (replenish stores) 1000ug)
nucleated RBCs B/B0 abx, hydration, pain control, (1% not absorbed
Tx: lifelong or B/B+ O2 (↓ sickling), transfusion, through IF pathway)
transfusion w/ iron no Tx
chelation (IV or oral) avoid hypoxia, immunization
re encapsulated bacteria.