1. ANEMIA DEFINITION & CLASSIFICATION
Maj Gen (R) Masood Anwar
Professor of Haematology

2. DEFINITION Functions of blood Composition of blood
Transport of nutrients
Transport of gases
Haemostasis
Defence
Composition of blood
Cells (RBC, WBC, Platelets)
Plasma (Colloids, Crystalloids, Water)

3. DEFINITION PYSIOLOGICAL DEFINITION
Decrease in oxygen carrying capacity of blood.
ANALYTICAL (PATHOLOGICAL) DEFINITION
Reduction in total circulating red cell mass
Reduction in Haemoglobin concentration and/or Haematocrit

4. RED BLOOD CELLS
These are blood cells produced in the bone marrow from a pleuripotent haemopoietic stem cell by processes of division, differentiation and maturation and released in the circulation to function mainly to transport oxygen from lungs to other tissues of the body.

5. RED BLOOD CELL

6. MEASUREMENT OF RED BLOOD CELL MASS AND INDICES
Haemoglobin (Hb)
Haematocrit (Hct)
[Packed Cell Volume (PCV)]
Total Red Blood Cell Count (TRBC)
Mean Cell Volume (MCV)
Mean Cell Haemoglobin (MCH)
Mean Cell Haemoglobin Concentration (MCHC)
Red Cell Distribution Width (RDW)

7. NORMAL VALUES PARAMETER ADULT MALE ADULT FEMALE Hb 13-17 g/dl
TRBC
X 1012/l
X 1012/l
Hct/PCV
40-54%/ l/l
36-49%/ l/l
MCV
76-96 fl
MCH
27-32 pg
MCHC
g/dl

8. CLASSIFICATION MORPHOLOGICAL CLASSIFICATION
Based on appearance of RBC under the microscope OR red blood cell indices
PATHOLOGICAL CLASSIFICATION
Based on abnormality of anatomical, biochemical or physiological abnormality
ETIOLOGICAL CLASSIFICATION
Based on specific causative process/agent

9. MORPHOLOGICAL CLASSIFICATION
Normocytic normochromic anaemia

10. MORPHOLOGICAL CLASSIFICATION
Hypochromic Microcytic Anaemia

11. HYPOCHROMIC MICROCYTIC ANAEMIA
Iron deficiency anaemia
Thalassaemia minor
Sideroblastic anaemia
Anaemia of chronic disorders

12. MORPHOLOGICAL CLASSIFICATION
Macrocytic anaemia

13. MACROCYTIC ANAEMIA Megaloblastic anaemia Aplastic anaemia Myxoedema
Chronic Obstructive Pulmonary Disease
Liver Disease
Myelodysplastic syndromes

14. PATHOLOGICAL CLASSIFICATION
Blood loss
Acute
Chronic
Decreased production
Disturbance of proliferation and differentiation
Of stem cells
Of erythroblasts
Defective Hb synthesis
Increased destruction
Intracarpuscular (Intrinsic) defects
Extracarpuscular (Extrinsic) defects

15. ETIOLOGICAL CLASSIFICATION
Hereditary
Blood loss – Hereditary Intestinal telengiectasia
Decreased production – Pure Red Cell aplasia
Increased destruction – Membrane, Enzyme and Hb defects
Congenital
Defective production – Congenital dyserythropoietic anaemia,Congenital sideroblastic anaemia
Increased destruction – Cardiac defects, vascular defects
Acquired

16. ACQUIRED ANAEMIAS Blood loss Acute Chronic Ulcerative lesions of GIT
Female reproductive system
Parasites – Ankylostoma duodenale, Schistosoma haematobium

17. ACQUIRED ANAEMIAS Increased destruction of RBC Membrane defect (PNH)
Mechanical trauma (Microangiopathies)
Antibody mediated (Immune haemolytic anaemia)
Parasites (malaria, Aroya fever)

18. ACQUIRED ANAEMIAS Decreased production Deficiency anaemias
Iron deficiency
Vitamin B12 and Folate deficiency
Bone marrow disease/infiltration
Miscellaneous
Pyridoxin responsive anaemia
Sideroblastic anaemia