Diseases Of The Blood Prof.Ahmed Mohy

Red blood cell Disorder Anemia Reduction in RBCS &/or haemoglobin/unit volume of blood with low or normal blood volume

Classification of Anemia → Hereditary (Intra corpuscular defect) → Acquired (Extra corpuscular defect 3-Bone Marrow hypofunction anaemia 4. Acute post Haemmorhagic anaemia 1-Deficiency anaemia 2-Haemolytic anaemia d.t : RBC destruction

Iron Deficiency anaemia Plummer- Vinson syndrome Middle aged women with iron deficiency anaemia 1. Glossitis 2. Atrophy of filiform papillae of the tongue 3. Atrophy of pharyngeal mucosa & dysphagia. 4. Stomatitis 5. Post-cricoid carcinoma

Iron Deficiency anaemia Microcytic and hypochromic

Megaloblastic anaemia -Macrocytic and hyperchromatic

Hemolytic anaemia Spherocytosis

Sickle cell anaemia

White Blood Cells disorders Neutrophilia Suppuration as abscess and appendicitis Infection Intoxications as lead poisoning. Metabolic disorders as diabetic ketosis, uremia. Bone marrow neoplasia as polycythemia vera. After acute haemorrhage. Anaphylactoid shock.

Neutropenia 1.Infections as typhoid, tuberculosis, influenza, malaria. 2.Intoxications as benzene.and sulphonamides 3.Hypersplenism. 4.Aplasia of bone marrow….. 5.Radiation.

Lymphocytosis a- Certain acute infections as whooping cough, chronic infections as tuberculosis and syphilis. b- Infectious mononucleosis (EBV). c- Infections in children.

Eosinophilia: a- Parasite.B,Hydatid disease,trichinosis b- Allergy : asthma and urticaria

Monocytosis: Tuberculosis malaria severe suppuration leukaemia.

Leukaemia Definition: malignant proliferation of WBC ‘s precursors in bone marrow. ↑ count + immature cells. In the blood and tissues Aleukaemic leukemia: normal count + immature forms in the peripheral blood.

Bone marrow

Leukaemia

Causes: 1.Viruses. 2.Chemical agents as benzene. 3.Ionizing radiation. 4.Chromosomal abnormalities

Leukaemia Classification: 1. Acute leukaemia 2. Chronic leukaemia Normal Total WBC: 4, ,000/mm2

Acute leukaemia: young children rapid and fulminating course. 1.high remittent fever 2.necrosis in mouth and throat 3.rapid anaemia 4.bleeding 5.enlargement of lymph nodes, spleen and liver.

Acute leukaemia: Haematological findings: WBC’s 100,000/mm2. Mostly: immature (blast cells) Marked normocytic, normochromic anaemia. Thrombocytopenia.

Acute myeloblastic leukemia(AML)

Chronic Myeloid Leuk.Chronic Lymphatic leukemia 1- IncidenceCommonLess common. 2- Age25 – 40 yr.40 – 60yr. 3- Haematologic finding. a- WBC's up to /mm2 -Neutrophils (myelocytic series) -eosinophils, basophils their precusor. b- Normocytic Normochromic anaemia d.t haemolysis or inadequacy of Bone marrow. c- Thrombocytopenia. d- Bone marrow hypercellular +blasts – /mm2 - lymphocytes - lymphoblasts - Late absolute leucocytic 4- Fate :Rapidly fatal.Slow course

CLL

6- Pathological Findings: Chronic Myeloid Leuk "CML" Chronic Lymphocytic leuk a ) Lymph nodes: Late. b) Spleen : Marked enlargement dark + infarction Mic : Atrophic lymphoid follicles. Leukemic infiltrate in red pulp. Myeloid metaplasia. a)Lymph nodes: Marked enlargement+ diffuse infiltration by lymphocytes b) Spleen: slightly enlarged hyperplasia lymphoid follicle.

Chronic leukemias c) Liver : enlarged. d) Haemorrhages : d.t thrombocytopenia. e) Anaemia + fatty change of parenchymatous organs. f) Secondary bacterial infection. g) Skin & mucous membranes : nodules (leukaemic deposits).