Anemia Definition Physiological Pathological Classification:

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Presentation transcript:

Anemia Definition Physiological Pathological Classification: I- ↓ production: 1)↓ precursors 2)Chronic infection, inflammation and Renal disease. 3)↓ specific factors. II-↑ destruction or blood loss.

Clinical features: Symptoms: Signs: pallor Fatigue Irritability Weakness Shortness of breath Decreased appetite Headache - frontal Pallor Others- according to type of anemia Hemic murmur and heart failure

Iron deficiency anemia Etiology: Decreased supply Increased requirement Decreased absorption Chronic blood loss Symptoms: Pallor Brittle nails Unusual food cravings (pica) Oral lesions; Sore tongue behavioral, cognitive and psychomotor deficits Note: There may be no symptoms if anemia is mild

Signs: Pallor Splenomegaly Nail changes Others.

Investigations: Blood: -Hypochromic microcytic anemia. -Poikiliocytosis. -platelets. -Reticulocyte count -S.I, TIBC, T.S, S.Ferritin -B.M. Stool

Treatment Iron therapy. Oral iron (ferrous sulfate) Diet. meats, liver, poultry, fish, leafy greens legumes. Ascorbic acid→↑ absorption & tannates (tea, coffee), Calcium, Phosphate, antacids, phytates ↓ absorption of iron. D/D: 1) Thalassemia trait. 2) Lead poisoning. 3) sideroblastic anemia.

Stages of iron deficiency 1) ↓ in iron stores. 2) ↓ S. Ferritin. 3) ↓ S. iron. 4) progressive anemia. 5) ↓ activity of I.C. enzymes. Response to therapy 1) ↑ I.C. Iron enzymes. 2) Initial BM response. 3) ↑ Reticulocytes (5-7d) 4) ↑ Hb% (4-30 d). 5) Repletion of iron stores.

Megaloblastic anemia A- Folic Acid Deficiency: 1) ↓ intake. 2)↑ requirement. 3) ↓ absorption. H.A, Anticonvulsants, Cytotoxic drugs & Sulfonamides. Clinical manifestations: 4-7 months. Lab. Data: 1- ↑MCV. 2- ↓S. folate 3- ↓Ret. Count. 4-Megaloblastic morphology. 5-Pancytopenia. Treatment: Oral folic acid.

B12 Deficiency ↓ intake. ↓ intrinsic factor. Interference with I. factor B12 complex. Disease of terminal ileum. Juvenile P.A. Clinical manifestations: 1) general. 2)glossitis. 3) neurological manifestations. Lab. Data: -Blood indices -Schilling test.

- secondary: drugs, toxins, infections, Radiation. Aplastic Anemia Genetic ( Fanconi anemia) Acquired - idiopathic - secondary: drugs, toxins, infections, Radiation. Fanconi anemia : - inheritence (AR) -age (7-8) - risk for cancer.

Congenital abnormalities: Short stature Thumb and arm anomalies - misshapen or missing thumbs, an incompletely developed or missing radius Other skeletal anomalies - hips, spine, and ribs Kidney malformations. Skin discoloration (cafe-au-lait spots) Microcephaly and micro-ophthalmia. Mental retardation or learning disabilities Low birth weight. Gastro-intestinal malformations. Small testicles. Heart defects.

Diagnosis: - Pancytopenia. -Chromosomal breakage. - Hypocellular BM. Treatment: 1) Supportive therapy. 2) Marrow stimulants. 3) Immunosuppressive therapy; ATG, corticosteroids. 4) BMT.

Thanks & Good luck