Anemia UPH

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R.

Dina Garniasih

Blood Smear
The blood smear is very helpful in the diagnosis of

anemia. It establishes whether the anemia is hypochromic, microcytic, normocytic, macrocytic or shows specific morphologic abnormalities suggestive of red cell membrane disorders (e.g., spherocytes, stomatocytosis or elliptocytosis) or hemoglobinopathies (e.g. Sickle cell disease, thalassemia).

The mean corpuscular volume (MCV) confirms the

findings on the smear with reference to the red cell size, e.g., microcytic (,70fl), macrocytic (.85fl) or normocytic (7279fl). The mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) are calculated values and generally of less diagnostic value. The MCH usually parallels the MCV. The MCHC is a measure of cellular hydration status. A high value (.35g/dL) is characteristic ofs pherocytosis and a low value is commonly associated with iron deficiency.

MCV and red cell distribution width (RDW) indices,

available from automated electronic blood-counting equipment, are extremely helpful in defining the morphology and the nature of the anemia and have led to a classification based on these indices.

An Approach to the Diagnosis of Anemia by Examination of the Blood Smear

Classification of Nature of the Anemia Based on MCV and RDW

Approach to the Diagnosis of Anemia by MCV and Reticulocyte Count

Causes of Normoblastic, Megaloblastic and Sideroblastic Bone Marrow Morphology

R. Dina Garniasih

Etiologic Classification and Major Diagnostic Features of Anemia Hemolytic

Etiologic Classification and Major Diagnostic Features of Anemia Hemolytic

The Clinical Features Suggestive of a Hemolytic Process

R. Dina Garniasih

Megaloblastic anemias are characterized by the

presence of megaloblasts in the bone marrow and macrocytes in the blood. In more than 95% of cases, megaloblastic anemia is as a result of folate and vitamin B12 deficiency. Megaloblastic anemia may also result from rare inborn errors of metabolism of folate or vitamin B12. In addition, deficiencies of ascorbic acid, tocopherol and thiamine may be related to megaloblastic.

Causes of Megaloblastosis

Causes of Vitamin B12 Deficiency

Causes of Folic Acid Deficiency

Causes of Folic Acid Deficiency

R. Dina Garniasih

A variety of systemic illnesses including acute and chronic

infections, neoplastic diseases, connective tissue disorders and storage diseases are associated with hematologic manifestations. The hematologic manifestations are the result of the following mechanisms: Bone marrow dysfunction Anemia or polycythemia Thrombocytopenia or thrombocytosis Leukopenia or leukocytosis. Hemolysis Immune cytopenias Alterations in hemostasis Acquired inhibitors to coagulation factors Acquired von Willebrand disease Acquired platelet dysfunction. Alterations in leukocyte function.

Pathophysiology of Anemia of Chronic Disease

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