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Measurement of transferrin
Smear: ovalocytes/ pencil form
RBC, Hb
Clinical Symptoms:
Hemoglobin levels:
<12 g/dL: male
<11 g/dL: female
o
o
o
Morphology
Etiology
o
o
Types of Anemia
2.
Relative Anemia
false anemia
RBC: normal, Plasma Volume:
Secondary to an unrelated condition
Transient
Cause: any condition that results to
HEMODILUTION
Example: pregnancy, volume overload
(plasma transfusion)
Absolute Anemia
true anemia
RBC: , Plasma Volume: Normal
Indicative of true decrease in RBC and
Hemoglobin
A.
1.
Prevalent in:
o
o
o
o
o
o
Laboratory Findings
-
Microcytic, Hypochromic
Serum iron, ferritin, Hb/ Hct, RBC indices,
reticulocyte count
TIBC (Total Iron Binding Capacity)
Hepcidin
-
Mechanism
Fatigue
Dizziness
Pica (appetite for non-nutritive food like
clay & wood)
Stomatitis (cracks along the corners of the
mouth)
Glossitis (sore tongue)
Koilonychia (spooning of the nails)
Liver hormone
Positive APR
hepcidin iron absorption
Functions:
Iron regulation
Influence intestinal iron absorption
Release of storage iron from
macrophage
Laboratory Findings:
-
3.
Normocytic, normochromic
Prolongation: slight microcytic,
hypochromic
ESR (normal: 20 mm/hr)
Normal/ elevated ferritin
serum iron, TIBC (as it does not feels the
need to bind iron due to normal or
ferritin)
Sideroblastic Anemia
Caused by blocks in the protoporphyrin
pathway resulting in defective
haemoglobin synthesis and iron overload
Ringed Sideroblast (immature RBC)
Mitochondrial region
Periphery of the nucleus
Siderocytes (mature RBC w/ sideroblastic
inclusions)
Wright Stain
Perls Prussian Blue (best)
Primary
Irreversible
Cause of clock is unknown
Present w/ RARS (Refractory Anemia w/
Ringed Sideroblast)
Secondary
Reversible
Caused by alcohol, anti-tuberculosis drugs,
chloramphenicol
Laboratory findings:
4.
Microcytic, hypochromic
ferritin, serum iron
TIBC
Lead Poisoning
Caused by multiple blocks in the
protoporphyrin pathway
Common on children exposed to lead
based paint
Clinical Symptoms
o
o
o
Abdominal pain
Muscle weakness
Gum lead line
Laboratory findings
-
Normocytic, normochromic
With coarse basophilic stipplings
5.
Step # 2
Accumulation of d-ALA excreted in the urine
Step # 7
Blocking of heme synthetase (ferrochelatase)
iron overload free radicals destruction of
cells
Porphyrias
Inherited disorder characterized by
blockage in the protoporphyrin pathway
Heme precursors before the block
accumulate in the tissues & large amount
are excreted in the urine & feces
Clinical Symptoms
o
o
o
o
Photosensitivity
Abdominal pain
CNS disorder (short/long term memory loss,
psychosis)
Flourice of skin and teeth
MEGALOBLASTIC ANEMIA
1.