ANAEMIA

ANAEMIA

ANAEMIAAnaemia is a clinical condition due to reduction in number of RBCs or less Hb estimation can produce anaemia. If the RBC count will decrease upto 1 million/µl of blood or the Hb estimation will be 8 gm% that will produce anaemia.

ETIOLOGICALCLASSIFICATIONIt is based upon the cause of disease:

• Haemorrhagic Anaemia: Any haemorrhage or blood loss can produce by acute reason or chronic reason for eg: In any accidental case of peptic ulcer there will be chronic anaemia due to blood loss.

Haemorrhagic Anaemia

• Haemolytic Anaemia Anaemia due to excessive destruction of the RBCs can produce anaemia. It may be exposure of some drugs or rays or gas poisoning

Haemolytic Anaemia

Haemolytic Anaemia

• Dyshaemopoiesis:It is abnormal haemopoiesis resulting aplastic anaemia. It is due to X rays, gamma rays, and some drugs which destroy the activity of bone marrow, So there is haemopoiesis dysfunctioning or destruction.

MORPHOLOGIC CLASSIFICATIONIt is based on size of the RBCs and its haemoglobin concentration• Pernicious Anaemia: (Addison’s Disease)It means destructive or injurious anaemia

Cause: This is due to lack of intrinsic factors and failure of absorption of vitamin B12 Characteristic Features: Anaemia produce hypoxia which results stimulation of erythropoiesis in bone marrow with maturation arrest (unmatured RBCs). Therefore, bone marrow becomes hyperplastic, (when bone marrow does over activity). The over activity of the bone marrow is called megaloblastic hyperplasia, more number of immature cells

• Changes of blood cells:

i. Count decreases less than 12gm/dlii. Haemoglobin content decreases less than 12gm/dliii. The diameter increases upto 8.2 µm.iv. MCHC is normal but MCV and MCH increases.v. In peripheral smear, RBC shows nucleated, WBC and platelets both

decreases.

• Changes in GIT (Gastrointestinal Tract)

i. Deficiency of intrinsic factorsii. Destruction of Gastric mucosa.iii. Soreness and inflammation of tongue , diarrhoea.

• Changes in Nervous system

In advance cases, demyelination of white fibre of the spinal cord which affect the dorsal column and lateral column which produce degeneration of the spinal cord. This is associated with tingling and numbness in hands and feet. It produces motor and psychological and disturbances.

Pernicious Anaemia

• Sickle cell anaemia: It is Hbs which is inherited as Mendelian dominant. Here, each ß peptide chain of Hb position6,1 glutamic acid is replaced by valine, therefore when Hb1 is reduced in low oxygen tension in low ph at tissue level, It becomes much less soluble than HbA. As a result , Haemoglobin precipitate in a crystal form within RBC• RBC Changesi. It damages the cell membrane producing increased fragility

of the RBCsii. Crystals are elongated and RBCs becomes hook shaped or

produced sickle shaped. So if blood flow decreases to the tissues due to increased viscosity of blood (BP increases)

iii. Sickle shaped anaemia, due to fragile RBCs and more viscosity of the blood produces severe anaemia with secondary infections

Sickle cell anaemia

• Megaloblastic Anaemia/ Folic Acid Deficiency Anaemia Folic Acid deficiency produces Megaloblastic Anaemia with Vitamin B12 deficiencyi. Less deficiency and poor absorption in

GITii. Increase demands during pregnancyiii. Anti cancer drugs or anti H foliate drugs

Megaloblastic Anaemia/ Folic Acid Deficiency Anaemia

Megaloblastic Anaemia/ Folic Acid Deficiency Anaemia

• Iron deficiency Anaemia Due to deficiency of ironCauses:i. Less dietary intake and poor absorptionii. Due to haemorrhage or bleeding maybe

acute and chroniciii. Defective utilisation due to poor

absorption in stomach and duodenum

• Characteristicsi. RBC is hypermic and microcyticii. MCV, MVH and MCHC decreasesiii. Bone Marrow is normoblastic hyperplasiaiv. WBCs and platelets are in normal in countv. Nails are dry, soft, spoon shaped and tongue

is angry red in colourvi. Serum billurubin less than 0.4 mg/dl serum

iron decreases but total iron binding capacity increases

vii. In CVS breathlessness repeated chest infection , headache, loss of concentration, irritability occurs in CNS

Iron deficiency Anaemia

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