1257000
Clinical Haematology
- Iron deficiency anaemia
- caused by defective synthesis of
haemaglobin, resulting in cell that are
smaller than normal (microcytic) and
contain reduced amounts of
haemoglobin (hypochromic)
- Iron stores comprise ferritin, a labile and readily
accessible source of iron, and haemosiderin, an insoluble
form found predominately in macrophages.
- LAB INVESTIGATION
- FBC, film.
- Confirm anaemia: reduced Hb
conc, reduced mean cell
volume (MCV), reduced mean
cell Hb, reduced mean cell Hb
conc.
- Reduced Hb late indication of deficiency.
- Some analysers
determine % of
hypchromic cells
- Reduced Hb late indication of deficiency.
- Microcytic
hypochromic red cells
with pencil cells &
target cells.
- Confirm anaemia: reduced Hb
conc, reduced mean cell
volume (MCV), reduced mean
cell Hb, reduced mean cell Hb
conc.
- Haematinic
assay
- demonstrate reduced serum
ferritin conc in straight forward
iron defeciency.
- as an acute phase protein,
serum ferritin conc maybe
normal or raised in inflammatory
or malignant disease.
- eg, rheumatoid disease.
- eg, rheumatoid disease.
- demonstrate reduced serum
ferritin conc in straight forward
iron defeciency.
- FBC, film.
- caused by defective synthesis of
haemaglobin, resulting in cell that are
smaller than normal (microcytic) and
contain reduced amounts of
haemoglobin (hypochromic)
- Macrocytic Anaemia
- rise in MCV of RBC above normal range
- causes of macrocytosis fall into 2 groups
- A) deficiency in vit B12/ folate
in which bone marrow is
megaloblastic
- Vit B12 usually due to
pernicious anaemia
- Blood film: oval
macrocytes,
hypersegmented neutrophil
nuclei.
- Severe case: WBC &
platelet count fall
(panocytopenia)
- Vit B12 usually due to
pernicious anaemia
- B) other causes,
in which the bone
marrow is
normoblastic
- A) deficiency in vit B12/ folate
in which bone marrow is
megaloblastic
- • Serum vitamin B12 assay • Serum and red cell folate assays • Liver and
thyroid function • Reticulocyte count • Serum protein electrophoresis • For
vitamin B12 deficiency: serum parietal cell and intrinsic factor antibodies,
radioactive vitamin B12 absorption with and without intrinsic factor
(Schilling test), possibly serum gastrin concentration • For folate
deficiency: antigliadin, anti-endomysial and antireticulin antibodies •
Serum antigliadin and anti-endomysial antibodies (intrinsic factor Ab &
peritenial cell Ab)
- rise in MCV of RBC above normal range
Want to create your own Mind Maps for free with GoConqr? Learn more.