20589_normocytic anemia [وضع التوافق]

8/11/2019 20589_normocytic Anemia [ ]

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DR. SOAD KHALIL AL JAOUNI

Associate Professor

Consultant HematologistConsultant Pediatrics Hematology/Oncology

Hematology Department

King Abdulaziz University

KAU, ALJAOUNI


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CLASSIFICATION OF ANEMIA

normochromic

-

Megaloblastic: vitamin B12 or

deficiency

MCV>26 pgMCV


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,

-

MCH>26 pgMany haemolytic anaemiasAnaemia of chronic disease (some cases)

After acute blood lossRenal disease

Mixed deficiencies e.g. (iron deficiency and

megaloblastic anemia)Bone marrow failure, e.g. post-chemotherapy,

infiltration by carcinoma, etc.

KAU, ALJAOUNI


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Macrocytic

MCV>95 fl

Megaloblastic: vitamin B12 or folatedeficiency

Non-megaloblastic:alcohol, liver disease,

,

Aplastic anaemia, etc.

KAU, ALJAOUNI


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A reduction in blood count of all major cell lines

Red cells:White cells:

KAU, ALJAOUNI


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Decreased bone marrow function Aplasia

Acute leukaemia, myelodysplasia, myeloma

Infiltration with l m homa solid tumours

Tuberculosis

Paroxysmal nocturnal haemoglobinuria

Haemophagocytic syndrome

ncrease per p era estruct on

Splenomegaly

KAU, ALJAOUNI


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Causes of aplastic anemia

Primary SecondaryCon enital Fanconi and Ionizin radiations: accidental ex osure

non-Fanconi types) (radiotherapy, radioactive isotopes, nuclear

power stations)

Idiopathic acquired Chemicals: benzene and other organic

, , , ,

chlordane, DDT

Drugs

Those that regularly cause marrow

depression(e.g. busulphan,cyclophosphamide, anthracyclines,

nitrosoureas)

KAU, ALJAOUNI


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Cont.

Those that occasionally or rarely cause

marrow depression (e.g.

chloramphenicol, sulphonamides, gold

and others)Infection: viral hepatitis (A or C)

KAU, ALJAOUNI


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Aplastic anemia is defined as pancytopenia resulting from aplasia of

bone marrow

A lastic anemia s ontaneous mucosal hemorrha e

KAU, ALJAOUNI


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Spontaneous bruising over the thigh & leg

Idio athic ac uired a lastic anemia

KAU, ALJAOUNI


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Fanconi Anemia

8 Years 9 Years

Short stature microcephacy

KAU, ALJAOUNI


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KAU, ALJAOUNI

- .

(b) Intravenous pyelogram in a patient with FA showing a normal right kidney but a leftkidney abnormally placed in the pelvis.


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A lastic anaemia: low ower views of bone marrow show severe reduction of

KAU, ALJAOUNIhaemopoietic cells with an increase in fat spaces (a) Aspirated fragment. (b) Trephine

Biopsy.


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Red Cell Aplasaia

-

3 Years typical face sunben bridge of nose

red cell a lasia

KAU, ALJAOUNI


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KAU, ALJAOUNIParvovirus infection: flow chart showing transient fall in haemoglobin and reticulocytesin a patient with hereditary spherocytosis


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ears au ema e a m e ru ecause o nose ee an

bleeding in the skin.

CBC .

Hb 5.0g/dl

MCV 89

Plt. 10/ul

Retic% 1.0

Blood Film .

1. What you would like to ask in the history?

2. What important in physical examination?

.

4. What is your provisional diagnosis?

5. What confirmatory test to confirm your diagnosis?

KAU, ALJAOUNI


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An excellent hematological response to ATG adult male

with severe aplastic anemia

KAU, ALJAOUNI


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With Compliment of:

Dr. Soad Al Jaouni

KAU, ALJAOUNI

20589_normocytic anemia [وضع التوافق]

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