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ANEMIA

ANEMIA. College of Medicine & KKUH 19/02/2015 Khalid Al- Anazi. Cytopenias. ** Low WBC counts: - Neutropenia - Lymphocytopenia - Monocytopenia ** Low Hb level: - Normocytic Anemia - Microcytic Anemia - Macrocytic Anemia ** Low PLT counts :

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ANEMIA

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  1. ANEMIA College of Medicine & KKUH 19/02/2015 Khalid Al-Anazi

  2. Cytopenias ** Low WBC counts: - Neutropenia - Lymphocytopenia - Monocytopenia ** Low Hb level: - Normocytic Anemia - Microcytic Anemia - Macrocytic Anemia ** Low PLT counts: - Primary - Secondary - Immune & non-immune ** Pancytopenia

  3. Common causes of anemia 1- Acute trauma and blood loss 2- Chronic infections e.g. hookworm and parasitic infections. 3- Chronic diseases e.g. chronic renal failure. 4- Nutritional anemia 5- Bone marrow failure syndromes: aplastic anemia & myelodysplastic syndrome 6- Neoplastic disorders: leukemia, lymphoma & solid tumors 7- Endocrine diseases & hormona imbalance 8- Immune mediated hemolytic anemia 9- DIC & toxin exposure

  4. The most common causes of anemia 1- Iron deficiency anemia 2- Thalassemia 3- Sickle cell disease 4- Aplastic anemia 5- Hemolytic anemia 6- Pernicious anemia 7- Fanconi anemia

  5. Classification of anemias 1- Microcytic hypochromic 2- Normocytic normochromic 3- Macrocytic

  6. Investigations of anemia

  7. Treatment of anemia * Rx of cause; symptomatic Rx; DIET * Supplements: iron; folate; vit B 12 * IV iron; blood transfusion

  8. Classification of hemolytic anemias * Hereditary or acquired * Immune or non-immune * Intravascular or extravascular; intracorpuscular or extracorpuscular * Warm antibody or cold antibody type * Membrane, enzyme or globin chain defect; drug-induced, infection or disease-related

  9. Hereditary hemolytic anemias - Sickle cell anemia - Thalassemias - Hereditary spherocytosis - Hereditary elliptosis - G-6-PD deficiency - Pyruvate kinase deficiency

  10. Acquired hemolytic anemias 1- Immune hemolytic anemias: (a) Autoimmune hemolytic anemia (b) Alloimmune hemolytic anemia (c) Drug-induced hemolytic anemia 2- Mechanical hemolytic anemia 3- Paroxysmal nocturnal hemoglobinuria 4- Infection-related hemolysis 5- Drug-induced hemolysis

  11. Causes of microangiopathic hemolytic anemia 1- HUS 2- TTP 3- Valve or arterial graft hemolysis 4- Mechanical: trauma and burns

  12. Drugs that commonly cause hemolysis 1- Antimalarials: chloroquine, promaquine 2- Antimicrobials: sulfonamides, chloramphenicol, bactrim, nitrofurantoin. 3- Miscellaneous: aspirin, dapsone

  13. Hemolytic anemia

  14. Causes of Normocytic Anemia A- Anemia of chronic illness: ** Anemia of chronic renal insufficiency ** Anemia of chronic liver disease; multifactorial ** Anemia of endocrine disease: - Addison's disease - Hypothyroidism B- Hemolytic anemias: ** Sickle cell disease C- Bleeding; acute blood loss D- Nutritional E- Early iron deficiency anemia F- Mixed Anemia [Iron/Folate/Vit B12 deficiency]

  15. Blood film of SCA

  16. Causes of Microcytic anemia 1- Iron deficiency anemia 2- Thalassemia; α , β 3- Sideroblastic anemia 4- Anemia of chronic illness 5- Anemia of inflammation 6- Lead poisoning

  17. Blood Film of Thalassemia

  18. Blood Film of IDA

  19. Differentiation IDA & Anemia of chronic illness

  20. Causes of Macrocytosis 1- Folate deficiency 2- Vitamin-B12 deficiency 3- Pernicious anemia 4- Alcohol intake 5- Pregnancy 6- Hypothyroidism 7- Liver disease 8- Hemorrhage & hemolysis 9- Myelodysplastic syndrome & aplastic anemia 10- Multiple myeloma and acute leukemia 11- Malabsorption syndrome 12- COPD 13- Copper deficiency 14- Splenectomy 15- Drugs & Toxins: ** Arsenic poisoning ** Bactrim ** Nitrous oxide poisoning ** Metformin ** Anti-retroviral Rx ** Hydroxyurea ** Anti-TB Rx ** Methotrexate

  21. Macrocytic anemia Common causes: 1- Diet: malmnutrition, malabsorption 2- Drugs: antifolate drugs, antimicrobials & anticonvulsdants 3- Alcohol intake 4- Liver disease 5- Thyroid disease 6- Malignancy: leukemia & myeloma 7- BM failure: MDS & aplastic anemia

  22. Clinical & laboratory manifestations of macrocytic anemia

  23. Blood film of ITP

  24. Blood Film of MAHA

  25. Complications of SCD

  26. Complications of blood transfusion

  27. How to minimize transfusion complication

  28. Blood Film of AML

  29. Blood Film of MDS

  30. BM Bx of Aplastic Anemia

  31. BM Bx of Myelofibrosis

  32. Malarial Blood Film [Plasmodium falciparum]

  33. THANK YOU

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