Professional Documents
Culture Documents
Patologi Klinik
FK UNSWAGATI
06092015
Hb A2
3% of adult Hb (2 2)
Hb F
1 % of adult Hb (2 2)
Blood
group
A
Antigen
Antibody
Donor to
Anti-B
Recipient
from
A, O
Anti-A
B, O
AB
AB
Neither
AB
A, B, AB, O
Neither
AntiA/Anti-B
O, A, B, AB
Prevention
Proper identification of patients, pretransfusion
Positive
(DAT)
Occurs
Patients
baseline
Allergic urticaria
Laryngeal edema and bronchospasm
1% of recipients
If coupled with another sign, such as fever,
Allergic Anaphylaxis
Anaphylactic or anaphylactoid
Respiratory involvement with dyspnea or stridor
Cardiovascular instability
hypotension, tachycardia, loss of
Volume Overload
Transfusion-related volume overload
Infuse smaller volumes more slowly
Bacterial Contamination
Hypotension, shock, fever and chills,
nausea and vomiting, and respiratory
distress
Gram stain and blood culture
Reaction Type
Treatment - Adult
Pediatric
Follow-up
Acute
Hemolytic
Reactions
Pediatric patients
should receive a
smaller loading
volume of fluid
in proportion to
their body
surface area.
Reaction Type
Treatment - Adult
Delayed
Hemolytic
Transfusion
Reactions
Pediatric
Follow-up
Reaction Type
Treatment - Adult
Pediatric
Follow-up
Allergic
Transfusion
Reactions
Pediatric dose: 3
mg/kg/dose in
intravenous drip over
of 20 minutes.
Reaction Type
Treatment - Adult
Pediatric
Follow-up
Febrile
Transfusion
Reactions
Severe shaking
Chills
Sepsis Due to
Bacterial
Contamination
of Donor Blood
Hemolytic anemia
Risk factors
Poor diet
Intestinal disorders
Menstruation
Pregnancy
Chronic conditions
Family history
Weakness
Pale skin
Tachycardia
Shortness of breath
Chest pain
Dizziness
Cognitive problems
Numbness or coldness in your extremities
Headache
Aplastic Anemia
Life-threatening anemia caused by a
decrease in the bone marrow's ability to
produce all three types of blood cells red
blood cells, white blood cells and platelets
Cause of aplastic anemia is unknown
autoimmune disease
Chemotherapy
Radiation therapy
Environmental toxins
Hemolytic Anemias
Red blood cells are destroyed faster than
bone marrow can replace them.
Autoimmune disorders can produce
antibodies to red blood cells, destroying
them prematurely
Hemolytic anemias may cause yellowing of the
Hereditary Spherocytosis
Mutations in the ankyrin molecule with a
secondary deficiency of spectrin along the
cell membrane
Reduced red cell stability
Does not affect oxygen carrying capacity
Splenic sequestration
chain
HbS
Chromosome16
5'
Chromosome11
5'
Normal (HbA)
CCTGAGGAG
-Pro-Glu-Glu-
567
-O2
+O 2
3'
3'
Abnormal(HbS)
CCTGTGGAG
-Pro-Val -Glu-
567
-O 2
+O2
OXY-STATE
DEOXY-STATE
- Thalassemia
Common in Asians
Deletion of globulin chain loci
4 possible degrees of thalassemia:
Silent carrier, loss of a single globulin gene
thalassemia trait, loss of a pair of globulin
gene
HbH disease, only a single gene is present
Hydrops fetalis, deletion of all globulin
TALASSEMIA
Symptoms
Headache
Dizziness
Pruritus
Fullness in the left upper abdomen
Erythema (face)
Shortness of breath
Orthopnea
Symptoms of phlebitis
Per l blood
Per l of blood
5,000 10,000
50 - 70%
2,000 7,000
Lymphocytes
20 - 40%
1,000 4,000
Monocytes
1 6%
50 600
Eosinophils
1 5%
50 500
Basophils
0 2%
0 - 100
Leukopenia
Decreased peripheral white cell count due to
Leukocytosis
Nonneoplastic elevation of WBC count
Neutropenia
Reduction in the number of granulocytes
(<1500/l)
Increased risk of infection
Reduced phagocytosis response
Neutropenia
Decreased or defective granulopoiesis
Aplastic anemia
Anti-neoplastic agents
Other drugs: chloramphenicol, sulfonamides,
chlorpromazine
Manifestation of Neutropenia
Infections
Signs and Symptoms
Malaise, chills, fever
Ulcerative necrotizing lesions of the mouth,
skin vagina and GI tract
Reactive Leukocytosis
Increase number of WBC
Common reaction due to a variety of
inflammatory states caused by microbial or
non-microbial stimuli
Usually non-specific
Causes of Leukocytosis
Polymorphonuclear leukocytosis
Eosinophilic leukocytosis
Allergic disorders
Monocytosis
Chronic infections
Lymphocytosis
1.
2.
3.
4.
Leukemia
Malignant neoplasm of the hematopietic
stem cells
BM replaced by unregulated, proliferating,
immature neoplastic cells blood
leukemia enter spleen, lymph nodes
Most common cancer in the paediatric age
Leading cause of death in children
between 3 and 14 years old
Classification of Leukemia
A.
According to cell type and state of cell
maturity
Acute or Chronic
B.
Congenital
Pelger-Huet anomaly
Bilobed and occasional unsegmented neutrophils
Autosomal recessive disorder
Neutrophil hyper-segmentation
Rare autosomal dominant condition
Neutrophil function is essentially normal
May-Hegglin anomaly
Neutrophils contain basophilic inclusions of RNA
Occasionally there is associated leucopenia
Thrombocytopenia and giant platelet are frequent
Alders anomaly
Granulocytes, monocytes and lymphocytes contain granules
which stain purple with Romanowsky stain
Granules contain mucopolysaccharides
Chediak-Higashi syndrome
Autosomal recessive disorder
Giant granules in granulocytes, monocytes and
lymphocytes
Partial occulocutaneous albinism
Depressed migration and degranulation
Recurrent pyogenic infections
Lymphoproliferative syndrome may develop
Treatment is BMT
Acquired
Toxic granulation
Dohle bodies
Pelger cells
Hypersegmented neutrophils
Features
Sudden onset (3 months)
Depressed marrow function
Bone pain and tenderness
Generalized lymphadenophaty
Splenomegaly, hepatomegaly
CNS: headache, vomiting
Early B cell
Pre-B cell
Mature B cell
Early T cell
Mature T cell
survival rate
BM transplant
Treatment
Selective radiation
Chemotherapy
1.
2.
3.
Induction
Intensification
Maintenance and consolidation
Insidious onset
Incidental findings during routine exam
sweats, malaise
Acute
2-4 months
Poor prognosis, palliative management
Hodgkins Lymphoma
Disorders primarily involving the lymphoid
tissues
Anatomical spread
Morphological presence of Reed-Sternberg
cells
60-90% cure rate
Manifestations of Hodgkins
A symptoms
Painless progressive enlargement of a single or
B symptoms
Fever, night sweat, weight loss
Fatigue, anemia
Non-Hodgkins Lymphoma
Involves lymphoid tissue and may spread
to various tissues
Mostly B cell (80%)
Cause may be viral or genetic
EBV
Immunosuppresed patients
AIDS
After organ transplant
Treatment
Early stage radiation
Late stage chemo and radiation
BM transplant