Week 1: Microcytosis

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Week 1 Microcytosis

• Anemia classification
• Micro-Hypo anemia
• CBC and histogram
• IDA
• Fe metabolism
• Fe studies

• Hb electrophoresis
• Stem cell theory
• RBC precursors
• EPO, ILs, cytokines
• Erythropoiesis

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RBC Precursors and Stem Cell Theory

• Rubriblast Pronomoblast
• Prorubricyte Basophilic Nbl
• Rubricyte Polychromatic Nbl
• Metarubrucyte Orthochromatic Nbl
• Reticulocyte
• Erythrocyte

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Erythropoiesis
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Rubriblasts to metarubricyte
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Metarubricyte
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Reticulocytes
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Sign and Symptoms of Anemia

• CBC HH, RBC, indices, morphology
• Pallor
• Weakness, dizziness, hypotension
• Jaundice (if hemolytic)
• Koilonychia in IDA
• Peripheral neuropathy with magaloblastic
• X-ray changes (eg, thalassemia)
• Splenomegaly, hepatomegaly (extramedullary)

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Morphologic Classification

• Normocytic Normochromic
• Microcytic Hypochromic
• Macrocytic

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Physiologic Classification

• Hemorrhage (acute vs chronic)
• Proliferation defect (eg, aplastic)
• Maturation defect (eg, metabolic,
  hemoglobinopathy)
• Hemolytic

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Microcytic Hypochromic Anemia

• Low MCV
• Morphologic clues
• Iron deficiency anemia
• Anemia of chronic disease
• Porphyria
• Hemoglobinopathies

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Hemoglobin Synthesis
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Iron Deficiency Anemia

• Fe metabolism and heme synthesis
• Dietary deficiency
• Chronic blood loss
• Vitamin C deficiency
• Serum Fe, ferritin, TIBC, saturation
• SSx of anemia, koilonychia, pica
• Tx and CBC changes

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Iron Deficiency Anemia CBC Report
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IDA bone marrow
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IDA After Treatment