Course title: Hematology (1) Course code: MLHE-201 Supervisor: Prof. Dr Magda Sultan Date : 19/ 12 / 2013 . Outcome : The student will know : -The types of hemolytic anemias -The diagnosis of hemolytic anemias - The types of hereditary hemolytic anemias.
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The student will know :
-The types of hemolytic anemias
-The diagnosis of hemolytic anemias
-The types of hereditary hemolytic anemias.
-The diagnosis of hereditary hemolytic anemias
-The laboratory tests needed for diagnosis
1 - hereditary (genetic ) 2 - acquired.
Intravascular hemolysis :Red cell destruction occurs in vascular spacee.geclinical states associated with Intravascular hemolacute hemolytic transfusion reactions severe burns physical trauma bacterial infections
Intravascular hemolysis :- laboratory signs of intravascular hemolysis: tests for hemolysis and aditionally: hemoglobinemia methemalbuminemia hemoglobinuria hemosiderinuria
Extravascular hemolysis :red cells destruction occurs in reticuloendothelial systeme.gscyrestem - clinical states associated with extravascular hemolysis :autoimmune hemolysis delayed hemolytic transfusion reactions hemoglobinopathies hereditary spherocytosis hypersplenism hemolysis with liver disease- laboratory signs of extravascular hemolysis: tests for hemolysis
*Peripheral blood smear microscopy:
Bone marrow smear microscopy:
* Erytrhroid hyperplasia
* The level of unconjugatedbilirubin in the blood is elevated.
* The level of lactate dehydrogenase (LDH) in the blood is elevated
*The direct CoombꞋs test is positive, if hemolysis is caused by an immune process.
*Increased excretion of urobilinogen in the urine
*Increasedstercobilinogen in the stool.
*Sometimes abnormal results of the osmotic fragility test
Hereditary Hemolytic anemia
The Hb is stable when oxygenated state and become unstable and polymerized on deoxygenated state
Sickle cell anaemia
The change in cell structure arises from a change in
the structure of hemoglobin.
A single change in an amino acid causes hemoglobin
Sickle cell hemoglobinanaemia
Hb 6-9 g/dl, high retics (5-15%), Normocytic anemia , target or anisocytosis
Hb electrophoresis Hb S 60-100 in SS
Parents sickle trait Hb AS
Means defective synthesis of one or more of the
globin chains which form normal hemoglobin. In
very severe form this globin is totally absent. The
defect may be in alpha chain ( thalassaemia),
Beta chain ( thalassaemia) or Delta chain (
Defective chain synthesis
Excess chain Precipitation
cell membrane damage
Circulating Red cell
Bone marrow expansion
skeletal changes & hyper metabolism
Complication and death
Hereditary hemoglobinspherocytosis (HS)Laboratory features - hemolytic anemia- blood smear-microspherocytes - abnormal osmotic fragility test, acidifiedglycerol lysis time - negative direct Coombs test
Student name :الشيماء مصطفي عبد العاطي
Title:Sickle cell anaemia
Student name : اميره اسعد يوسف
Title : Haemoglobin electrophoresis .
Student name :اميره صلاح مرشدي
Title :G6PD deficiency .
Student name :انجي عبد الموجود
Title : Spherocytic anaemia .
Student name : بسمه مهدي رياض
Title :Laboratory tests of hemolytic anaemias .