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Normocytic anemia
•Chronic disease anemia (hepatic, renal or endocrine disorders) •Primary bone marrow disorders (aplasia, myelodisplasia, myelofibrose, hematologic and solid tumors, HIV infection, granulomas •Hemolytic anemia
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பைடு நூலகம்
Clinical manifestation
1、nervous system： 、 ： headache、dizzy、dispirited、faint、ear noises、dim eyesight 、 、 、 、 、 、 memory impairment、impaired concentration；acroanesthesia , 、 ； intelligence development abnormality 2、skin and mucosa：pallor；rough ；ulcer, stained yellow, 、 ： ； Koilonychia 3、espiratory apparatus：accelerated breathing ；short breath、 、 ： 、 4、digestive system：abdominal distention、anorexia, bowel 、 ： 、 disturbance, swallow foreign body sensation；Decreased food appetite; ； mirror surface tongue
Anemia
PNH hereditary spherocytosis G6PD deficiency hemoglobinopathy porphyrinopathy
immunologic, chemical, biological, or phisical factors 16
Classification: according to etiology/pathogenesy
ANEMIA
Tian jin Medical University, College of Nursing
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Introduction
Anemia is a commonly encountered clinical symptom that is caused by an acquired or hereditary abnormality of red blood cells (RBC) or its precursors, or may be a manifestation of an nonhematologic disorder hematologic hematology adj. n.
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Classification: according to etiology/pathogenesis
etiology/pathogenesis
Decreased RBC production Increased RBC destruction Blood loss
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Classification: according to etiology/pathogenesy
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Classification: according to etiology/pathogenesis
Increased RBC destruction 1. RBC internal defect (1)RBC membrane defect acquired: hereditary : (2) enzyme deficiency: (3) Hb abnormality (4) porphyrin metabolism 2. Exopathic
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Deficient RBC Production
Neoplasia Leukemia Metastasis to bone marrow Osteogenic sarcoma Myelofibrosis Pernicious anemia Iron Deficiency anemia Aplastic anemia Chloramphenicol administration Renal disease (lack of erythropoietin production) Increased RBC destruction over erythropoiesis
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Definition
Anemia is defined as a decrease in the circulating RBC or hemoglobin and a corresponding decrease in the oxygencarrying capacity of the blood. Normal values of the hemogram: TEST HCT (%) Hb (g/L) RBC Count(1012/L) HCT:Haematocrit WOMEN 37-43 11.3-13.5 3.83-4.83 Hb:hemoglobin MEN 42-49 12.7-15.3 4.29-5.58
Decresed RBC production
Anemia
1. BM stem cells abnormality AA 2. BM injured by abnormal tissues/cells Leukemia 3. Cell dysmaturity (1). DNA dyssynthesis Megaloblastic anemias (2). Hb dyssynthesis IDA 4. Abnormality in haematopoiesis modulation AA
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Classification: according to Bone marrow proliferative degree
Bone marrow
anemia
hyperplasia IDA, hemolytic anemia, blood loss anemia Hypoplasia AA, PRCA Dysmaturity(ineffective erythropoiesis) myelodysplastic syndrome(MDS) Megaloblastic anemias
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Clinical manifestation
9、hematological system： 、 ： peripheral blood: blood cell count, appearance and biochemical component； ； plasma ,serum hematopoietic organ :BM , liver , spleen, lymph node 10、genital system ： 、
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Microcytic anemia
•Iron Deficiency •Thalassemia
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Classification according to severity
Degree
Hb g/L Hb（g/L）
Mild anemia 90～120 ～ Moderate anemia 60～90 ～ Severe anemia ＜60 Very Severe anemia ＜30
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Clinical manifestation
5、urinary system：bilirubinuria 、hemoglobinuria、 、 ： 、 urinary siderosis；ARF ；
6、circulating system：peripheral vaso-constriction， 、 ： ， Palpitation, congestive heart failure 7、endocrine system： endocrine functional abnormality 、 ： 8、immune system： 、 ：
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Diagnosis
complete diagnosis 1. anemia 2. Degree of anemia 3. Classification of anemia 4. Cause of anemia
＞100 80～100 ～ anemia ＜80
MCV：mean corpuscular volume ； MCHC：mean cell hemoglobin concentration
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Macrocytic anemia
•Megaloblastic anemias ( folic acid and vitamin B12 deficiency) •Alcoholism •Drugs •Liver diseases •Primary bone marrow disorder •Hypothyroidism •Splenectomy
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cell morphological classification
cell morphological type
MCV（fl） MCHC (%)
32～35 ～ 32～35 ～ ＜32
Macrocytic anemia Normocytic anemia
Microcytic hypochromic
Blood loss 1. Acute blood loss 2. Chronic blood loss
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Clinical manifestation
Related factor; 1. cause of anemia 2. Degree of decrease of oxygen carrying capacity 3. Degree of decrease of blood volume 4. Speed of anemia genesis 5. Compensation and tolerance of blood and other