ERYTHROCYTE II (Anemia Polycythemia). HMIM BLOCK 224. Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College. Objectives. Classify anemia Differentiate between different types of anemia Write normal values for RBC, Hb , HCT [PCV], MCV, MCH, MCHC Define Polycythemia
HMIM BLOCK 224
Dr. ShaikhMujeeb Ahmed
- Decreased hemoglobin
- Decreased RBC count
- Decreased Hematocrit [PCV]
It is caused by dietary deficiency of factors needed for Erythropoiesis.
1.Dietary Deficiency of Iron
Iron deficiency anemia is called microcytic hypochromic anemia as RBC is small with less Hemoglobin.
- It is due to deficiency of Intrinsic factor produced by Parietal cells of stomach.
- Intrinsic factor is necessary for absorption of Vitamin B12.
- Vitamin B12 is absorbed from intestinal tract [terminal ileum] when Vitamin B12 is bound to intrinsic factor.
- Pernicious Anemia is megloblastic anemia.
3. Aplastic Anemia
It is caused by failure of bone marrow to produce RBC even though all necessary nutrients for Erythropoiesis are available.
Causes of Aplastic Anemia
-Excessive exposure to X-ray
-Exposure to radiation, e.g. bomb blast
-Chemotherapy for Cancer
4. Hemolytic Anemia
It is caused by rupture [breakdown] of RBC.
Causes of Hemolytic Anemia
-Sickle Cell Anemia [Hemoglobin β chain is defective where valine replaces glutamate at position 6 in this amino acid chain].RBC is sickle shaped
-Mismatched blood transfusion
5. Renal Anemia
Anemia in Renal [kidney] disease is due to decreased Erythropoietin secretion from the kidney. It leads to decreased RBC production.
6 .Hemorrhagic Anemia
- It is caused by losing a lot of blood.
- Acute Loss of blood e.g. car accident.
- Chronic Loss of blood e.g. bleeding peptic ulcer, excessive menstrual flow.
We will define MCV, MCH, MCHC
- Normal MCV = 90 fL or 90 μ3
[MCV > 95 fL are called macrocyte]
[MCV < 80 fL are called microcyte]
- Normal MCH = 30 picogram [pg]
- Normal MCHC = 30 gram/100ml of RBC
Microcytic Hypochromic Anemia
Or Iron Deficiency Anemia
Macrocytic [Megloblastic] Anemia
Vitamin B12 or folic acid deficiency
It is called Macrocytic Normochromic Anemia.
RBC count 3.6 × 106 / mm3
Hb concentration 7.0 g / 100ml
MCV 69.4 fL [femtoliter] Normal 90 fL
MCH 19.4 pg [picogram] Normal 30 pg
MCHC 28 g / dl Normal 34 g/dl
Types of Polycythemia
1. Primary Polycythemia
2. Secondary Polycythemia
- As there is increased viscosity of blood, it causes blood to flow very slowly, which may reduce O2 delivery to tissues.
- Increased viscosity causes increased peripheral resistance which may cause increased blood pressure.
Effect of Anemia
Effect of Polycythemia