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K-04 Anemia Penyakit Kronik
K-04 Anemia Penyakit Kronik
K-04 Anemia Penyakit Kronik
ANEMIA OF CHRONIC
DISORDERS (ACD)
IRON
a.
b.
PROTOPORPHYRIN
Iron deficiency
Chronic inflammation
/ malignancy
Sideroblastic anemia
Haem
Globin
Thalassemia
( or )
Haemoglobin
12/11/16
PATHOGENESIS
4
Inhibits macrophage
release of iron
Inhibits iron
absorption12/11/16
INVESTIGATION OF A HYPOCHROMIC
MICROCYTIC ANAEMIA
MCV / MCH
BLOOD FILM
SERUM IRON
SERUM IRON
SIDEROBLASTIC
ANAEMIA
SERUM IRON N /
HAEMOGLOBIN
STUDIES : Hb F/
HbA2
THALASSAEMIA,
ABNORMAL
HAEMOGLOBIN
SERUM IRON
FERRITIN LEVEL
Ferritin
Ferritin N /
IRON
ANAEMIA OF
DEFICIENCY
CHRONIC DISORDER
12/11/16
Lewis SM, Bain BJ, Bates I. Dacie and Lewis practical haematology. 9 th ed. London : Churchill Livingstone; 2001.p.582.
LABORATORY FINDINGS
7
Hypoferremia
Normochromic
Serum
BM
Reduced
Laboratory findings
Hepatocyte
Ferritin
Acute-phase
reactans
Phagocytic
activity
Albumin
Transferrin (TIBC)
IL-1
CRP
LABORATORY DIAGNOSIS OF A
HYPOCHROMIC ANAEMIA
10
Iron deficiency
Chronic inflammatory
or malignancy
MCV
MCH
Serum iron
Reduced in relation to
severity of anaemia
Reduced
Normal or mild
reduction
Reduced
TIBC
Raised
Reduced
Serum transferrin
receptor
Serum ferritin
Raised
Normal/low
Reduced
Normal or raised
Absent
Present
Absent
Absent
12/11/16
Hoffbrand AV, Moss PAH, Pettit JE. Essential haematology .5th ed. Oxford : Blackwell Publishing; 2006.p.39.
TREATMENT
11
12
THANK YOU
12/11/16