M6: RBC Disorders (Types of Anemia due to Decreased
RBC Production)
By: Jan Trisha S. Hombrebueno
MAIN TOPIC
TOPIC OUTLINE
1 Different types of Anemia
2 Topic 2
3 Topic 3
4 Topic 4
5 Topic 5
ANEMIA
- Decreased oxygen carrying capacity of the blood
- it is NOT A DISEASE, but is merely a symptom
of an underlying condition
Laboratory Findings:
 Decreased (↓) RBC Count
 Decreased (↓) Hgb
 Decreased (↓) Hct
Hgb- HEMOGLOBIN Hct- HEMATOCRIT
Caused by:
 Blood loss
 Accelerated RBC destruction
 Decreased RBC Production
DIFFERENT TYPES OF ANEMIA
NORMOCYTIC ANEMIA (NORMAL MCV)
NORMOCY 1 Aplastic Anemia
TIC 2 Myelophthisic Anemia
ANEMIA 3 Chronic Dyserythropoietic
Anemia
NORMOCYTIC ANEMIA
APLASTIC ANEMIA
 rare but potentially fatal bone marrow failure
condition
 Aplastic is derived from a word which means
absence
 Plastic which means plasia, which means
growth
 Meaning there is a complete absence of
growth in your bone marrow however the
better term for this would be
 Hypoplastic anemia- better name since there’s only
decrease (hypo) in growth but there’s still some
proliferation of new blood cells; this is what
happens under normal conditions
 AT NORMAL CONDITIONS your bone marrow
will have enough hematopoietic cells that will
mature to become your blood cells
 However, in cases of APLASTIC ANEMIA, the
bone marrow fails to produce enough
hematopoietic cells leading to producing
insufficient mature blood cells
o This will then lead to PANCYTOPENIA-
which means there’s a decrease (penia) of all
(pan) cells (cyto) particularly blood cells
o Not only the RBCs is decreased but also the
WBCs, and the platelets
POSSIBLE CAUSES
1 Decreased Erythropoietin (EPO) Production
 Renal Failure
- The kidneys are the site of APO production and
therefore, if the kidneys are damaged, then they
will not be able to produce enough erythropoietin.
The anemia due to renal failure is also termed,
“Anemia of Renal Disease”
 Hypothyroidism
- May also cause anemia because if there is there is a
decrease in the thyroid hormone, then this will put
the patient under oxidative stress and will lead to a
state of hypoxia. May also be described as,
“Anemia of Endocrine Disease”
2 Decreased EPO effectiveness
 Loss of EPO receptors (in erythroid stem cells)
- In this type of cases, even if the erythropoietin is
normal or elevated, if the erythroid stem cells are
not able to detect them due to the loss of receptors,
then the bone marrow would still produce a
decrease amount of blood cells.
 Infectious hepatitis
- May also affect the effectiveness of erythropoietin.
3 Damage to bone marrow (BM) by Ionizing
Radiation
 Constant exposure to X-rays, gamma rays and
neutrons
- Since the bone marrow is a part of the body that is
responsible for blood cell production, if the bone
marrow is already destroyed or damaged, then it
will not be able to perform its job or function.
4 Damage to BM by Toxic Chemicals
- If the bone marrow is already destroyed or
damaged by the different toxic chemicals, such as
benzene and chloramphenicol, then it will not be
able to do its functions properly
 Benzene
 Chloramphenicol
5 Replacement of Normal Hematopoietic Tissue
by Tumors
 Myelophthisic anemia
- In this case, the problem is not with the
hematopoietic tissue, however, the tumors are up
taking the space that is meant for the hematopoietic
cells and that is the cause of anemia.
TYPES OF APLASTIC ANEMIA
INHERITED
1 Fanconi Anemia
- is not fanconi syndrome. They just have the same
AUTHOR’S INITIALS
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M6: RBC Disorders (Types of Anemia due to Decreased
RBC Production)
By: Jan Trisha S. Hombrebueno

name but they have completely different however, yung WBC and platelet this would be
pathophysiologies and clinical manifestations. decreased since again aplastic anemia leads to
- Meron ding pancytopenia dito (although ↓ RBC, pancytopenia
but normal WBC and PLT)  If you check the bone marrow cellularity, this
would be described hypoplastic because again,
 Commonly seen in children. mababa yung number ng hematopoietic cells inside
 Autosomal recessive or X- linked recessive the bone marrow
 There are many different genes that can cause  Serum iron- increased since again instead of being
fanconi anemia. used for RBC production, maiiwan lang sa serum
yung iron ng patient.
CLINICAL MANIFESTATIONS:  Lastly, erythropoietin would be normal since
 Physical malformations erythropoietin is produced by the kidney to
- There is abnormal structure of the hands. stimulate the RBC production.
 Aplastic anemia  In fact, in cases of anemia, this would actually be
2 Pure Red Cell Aplasia elevated. Your kidneys would be stimulating
- Only the red cell are affected increased erythropoietin production. Sometimes in
- Ribosomal cases of aplastic anemia, erythropoietin may also
be increased.
 Immune suppression of erythropoiesis ACQUIRED
 ONLY RBCs are affected 1 Cytotoxic drugs
 Either there are antibodies against erythroid 2 Benzene
precursors or the lymphocytes of the patient attack 3 Radiation
the erythropoietic cells because of this, only the 4 Infections
RBCS are affected and WBCS and PLTS remain - The different types of infections that can cause
normal aplastic anemia would be viruses like hepa B,
3 Diamond-Blackfan Anemia hepa C, measles, Epstein- Barr virus,
- Exhibits Pure Red Cell Aplasia cytomegalovirus, as well as parvovirus.
- RPS19 gene
MYELOPHTHISIC ANEMIA
 Autosomal dominant inheritance 
 Usually caused by mutation in the RPS19 gene. TER  Definition
 There are many different types of mutation of this M
specific gene, however, the main idea is that this NOTE
leads to defective ribosome function, thus leading  Additional info
to anemia.
LABORATORY FINDINGS
LABORATORY RESULTS TOPIC 2
FINDINGS  Info about topic 2
RBC count, Hemoglobin Decreased  Info about topic 2
& Hematocrit
Reticulocyte Count MCV, ENUMERATION
MCHC 1  Info
Reticulocyte Count Decreased
MCV, MCHC Normal CHECKLIST
WBC count, PLT count Decreased ü
Bone marrow cellularity Hypoplastic ü
Serum iron Increased ü
Erythropoietin Normal
 RBC, HGB, HCT- decreased 2  Info
 Retic Count- decreased, since the problem here is 3  Info
inadequate hematopoiesis 4  Info
 MCV and MCHC- normal since the problem in
aplastic anemia is not in the quality of your red TOPIC 3
cells, its with the quantity
 Hindi talaga magiging abnormal yung MCV and Insert photo
MCHC since normal naman yung structure ng rbcs

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M6: RBC Disorders (Types of Anemia due to Decreased
RBC Production)
By: Jan Trisha S. Hombrebueno

SUBTOPIC 1
Term  Definition

For information that needs emphasis

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