INTRODUCTION TO ANEMIA

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INTRODUCTION TO ANEMIA

• Definition.
• Age, Sex and other factors.
• Causes of Anemia.
• Clinical diagnosis.
• Classification of Anemia.
• Laboratory Tests in the diagnosis of anemia.

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Anemia Inability of blood to supply the tissue
with adequate oxygen for proper metabolic
function. i.e. anemia is considered to be
present if hemoglobin concentration of RBC or PCV
(Hct) is below the lower limit of the normal
range (95 reference interval). Diagnostic
criteria for anemia are ? Hb, Hct or RBC.
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Considerations by Age, sex and other factors

• New born infant
• ?1 week Hb 14-22 g/dl
• 6 month old Hb 11-14 g/dl
• 1-15 years Hb 11-15 g/dl
• Adult
• Male Hb 13-17 g/dl
• Female Hb 12-15 g/dl

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Other factors

• Geographical factor
• High altitude (8000 feet) may have high Hb level.
• Different population (Asia and Europe).
• Various diseases.

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Causes of anemia

• Blood loss (internal or external hemorrhage).
• Nutritional deficiency (Folate, B12 or Iron).
• Accelerated destruction of RBC (immune non
  immune hemolysis).
• BM replacement (cancer).
• Infections.
• Toxicity.
• Hematopoietic stem cell arrest or damage.
• Hereditary (G6PD, Sickle cell anemia).
• Idiopathic.

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Clinical diagnosis

• Patient history
• Signs and symptom non specific
• Fatigue, weakness, faintness, headache and heart
  palpitation
• Physical signs
• Pallor, low BP, a slight fever.
• Changes in hematologic profiles
• Laboratory investigation
• Quantitation and Semi-quantitation of RBC indices

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Quantitation

• Three lab manifestations of anemia include
• - a decrease Hb concentration.
• - a reduced Pack Cell Volume (Hct) level.
• -a decreased RBC count and other indices.

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Semi-Quantitative

• Microscopic Examination
• RBC morphology
• Normochromic Normocytic.
• Hypochromic Microcytic.
• Hyperchromic Macrocytic.

Depends on classification
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• RBC indices and other tests
• Hb
• Hct
• RBC indices (MCV, MCH, MCHC)
• Blood Smear
• Reticulocytes count
• BM smear

References Essential Haematology (Hoffbrand
Pettit) Clinical Hematology Fundamentals of
Hemostasis (Denise Harmening).