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0 ANEMIA Definition ↓ Oxygen carrying capacity of blood due to decrease RBC ’ s or decrease hemoglobin content Discuss blood indices indifferent types of anemia? Normocytic Normochromic Anemia Microcytic Hypochromic (Iron Deficiency Anemia) Macrocytic Anemia (Megaloblastic Anemia) • ↓Number • Normal MCV • Normal MCH =25-32 pg • ↓Number • ↓ MCV < 80 u3 • ↓ MCH < 25 pg • ↓ number • ↑ MCV >95 u 3 Causes 1- Hemolytic Anemia (↑breakdown) → causes jaundice A- Intrinsic disorder: • Hereditary spherocytosis (see later) • G-6-PD deficiency (see later) • Sickle cell anemia (see later) B- Extrinsic disorder: • Bacterial toxins • Chemicals • Drugs • Erythroblastosis fetalis • Incompatible blood transfusion C- Hemorrhagic Anemia due to acute (sudden, rapid) Blood Loss • Body replaces plasma in 2 days → diluted blood • RBCs within 4 -8 weeks D- Aplastic Anemia ( ↓all blood cells ) Causes: Bone Marrow Depression due to X ray , irradiation Causes : • Iron Deficiency • Thalassemia Causes : • Vitamin B12 deficiency • Folic acid deficiency Causes of vitamin B12 deficiency: due to failure of absorption, not due to deficiency in diet except in vegetarians. • Absence of intrinsic factor ( Pernicious anemia ): f amilial disease of elderly women (immune reaction against parietal cells → cell destruction →↓HCL , intrinsic factor) • Gastrectomy • ↓ Absorption : diseases of lower ileum (distal small intestine) • ↓ store: Liver diseases: ➢ Effect of deficiency: Macrocytic anemia (bigger irregular fragile cells) & Neurological symptoms ➢ Treatment : Vitamin B 12 injection. Hb content MCH x 10 RBC's count = 3 95 u - = 80 X 10 Value Hematocrit MCV = RBC’s coun t
1 Causes of folic acid deficiency : • ↓ Intake (dietary deficiency)/ ↑need ( pregnancy) • ↓ Absorption → Diseases of small intestine. • Treatment of cancers with antifolate cytotoxic drugs (methotrexate) Causes of iron deficiency: 1- ↓ intake 2- ↓absorption • Partial gastrectomy (↓ HCl) (achlorhydria), Vitamin C deficiency, • ↑Phytic acid, oxalates, and phosphates in diet • Diseases of duodenum 3- Chronic blood loss: ancylostomiases, bleeding peptic ulcer, piles, excessive menstruation
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Types and Causes of Anemia