Blood and Blood Forming Organs Diseases and Disorders

{

Blood and Blood Forming Organs

Diseases and Disorders

Shelby Engel and Sarah Heins

Blood transports necessary nutrients and hormones Color, volume, viscosity, and pH RBCs/erythrocytes – transport oxygen

4.2-6.3 million live 120 days Hemoglobin typically 13.5-18g/100 ml for males, 12-16 for females

WBCs/leukocytes – infection prevention 4,500-11,000 count >11,00 indicates infection

Platelets/thrombocytes cause blood coagulation Clump at site of injury Calcium builds at site Fibrin clot is formed Clot is removed, scar tissue

A, B, AB, O +/- blood classified by antigens in blood Blood forming organs

Lymph nodes – protection from pathogens Bone marrow – major blood cell-producing organ Spleen – produces lymphocytes, plasma cells, and antibodies; filters

microorganisms in blood, removes old blood from body Liver – blood-forming organ; aids in blood coagulation

Anatomy & Physiology

Increases or decreases in production of cells – RBC, WBC, Platelets

Common Signs & Symptoms

HIGH VOLUME LOW VOLUME

RBC

Erythrocytosis - reddened skin tones, bloodshot eyes, increased blood volume and pressure, increase in heart workload

Erythrocyopenia leads to anemia – headache, fatigue, pallor, shortness of breath

WBCLeukocytosis – response to acute infection

Leukocytopenia – weakened immune system

PLATELETS

Thrombocytosis – no serious side effects

Thrombocytopenia – clotting problems, bruising, nosebleeds, blood lesions

Complete blood count – identifies RBCs, WBCs, and platelets; see page 128 in book

Differential – more detailed count, identifies the number of each type of leukocyte

Hematocrit – reflects the amount of red cell mass as a proportion of whole blood

Hemoglobin – reflects oxygen-carrying potential available Mean corpuscular volume – average size of RBC Mean corpuscular hemoglobin – average hemoglobin content Mean corpuscular hemoglobin concentration – average

hemoglobin concentration Blood smears Biopsy of blood-forming organs Bleeding time test – prick earlobe and measure time until

clot

Diagnostic Tests

Anemia Iron Deficiency Anemia Folic Acid Deficiency Anemia Vitamin B12 Deficiency Anemia Pernicous Anemia Hemolytic Anemia Sickle Cell Anemia Hemorrhagic Anemia Aplastic Anemia

Polycythemias Polycythemia (Primary or Vera) Secondary Polycythemia (Erythrocytosis)

Disorders of Red Blood Cells

Anemia = Most common A decrease in RBC mass that can be caused by a number of

different processes Can be serious enough if not determined or corrected

Symptoms: Shortness of breath and headache Rapid heart beat Dizziness Pale skin Weakness and fatigue

Treatment –Depends on the type of anemia Prevention – Eating a healthy diet with foods high in iron

and b complex vitamins

Vitamin B12 Deficiency Anemia Results from dietary deficiency in B12 or inability of the

digestive tract to absorb it

Can be related to poor diet, overcooking vegetables, and alcoholism Infancy and pregnancy

Symptoms: Fatigue Weight loss Abdominal pain Black or bloody stools Chest pain

Treatment – Increase intake of green leafy vegetables, mushrooms, lima beans, and kidney beans

Prevention – Diet high in folic acids

Folic Acid Deficiency Anemia

Usually affects older individuals and has an unusual cause

People affected usually have an autoimmune disorder Symptoms:

Pallor (paleness) Weakness Confusion Depression Numbness in the hands and feet

Diagnosis – History, physical examinations, and blood testing for vitamin B12

Treatment – Depends on the cause of the deficiency Absorption and diet – can be treated with oral vitamin

tablets or injectable vitamin B12 Monthly injection for life

Not preventable

Pernicous Anemia

Increased destruction on RBCs Can be severe and lead to death Can be brought on by exposure to chemicals such as

benzene; medications, including aspirin and penicillin; and bacterial toxins

Symptoms Pallor (paleness) Weakness Fatigue Tachycardia (rapid heart rate)

Diagnosis – thorough history, physical examinations, and blood testing

Prevention – Genetic = not preventable; Acquired = preventable with proper screening

Hemolytic Anemia

Hereditary anemia found in the African-American race Causes an abnormal sickle shape of the erythrocyte Thought to have developed a defense against malaria

Symptoms: Can be very mild to severe Pain in the back, legs, and abdomen (most common) Fatigue Irritability Swollen joints Leg sores Gum disease

Sickle Cell Crisis – Group of symptoms, pain is compared to cancer pain

Sickle Cell Anemia

Diagnosis – History and blood testing Two blood tests

1st = Measures the amount of normal and abnormal hemoglobin in the blood

2nd = Measures the percent of red sickle cells after mixing a small drop of blood with a deoxygenating agent

Treatment – No cure and treatment is symptomatic Increased fluid intake can help by increasing blood

volume and improve sickle cell movement Prevention – Genetic counseling and decision

to avoid childbearing

Sickle Cell Anemia cont.

Loss of whole blood and can be called blood loss anemia Common complication = hypovolemic shock

Symptoms Pallor (paleness) Cool clammy skin Tachypnea Tachycardia

If large amounts of blood is lost symptoms can include: Dizziness Fainting Extreme thirst (result from dehydration)

Diagnosis – History and physical examinations Treatment – Acute blood loss = apply oxygen, intravenous

fluids and liquids taken by mouth; Severe blood loss = blood transfusion

Prevention – Accident prevention and controlling chronic bleeding

Hemorrhagic Anemia

Failure of bone marrow to produce blood components Due to injury or destruction of blood-forming area of the

bone marrow Causes : Chemotherapy, radiation, viruses, and chemical

toxins Symptoms: This decrease in blood cells leads to

anemia, infection, and hemorrhage Diagnosis – History and physical examination with

blood testing Treatment – Severe cases have a poor prognosis with

50% fatality Discontinuing or avoiding the causative agent Bone marrow transplantation or blood transfusion

Prevention – Avoiding causative agent, but often the agent is unknown which makes prevention impossible

Aplastic Anemia

Condition of too many blood cells Caused by hyperplasia of the cell-forming tissues of the bone

marrow Symptoms:

Raised blood pressure Enlarged spleen Bloodshot eyes Redness of skin Shortness of breath Dizziness

Diagnosis – Can be accidently discovered through routine blood testing

Treatment – Reduce the red cell count, blood removal at regular intervals will reduce the volume (common treatment)

Prevention – Cannot be prevented

Polycythemia (Primary or vera)

Red cell numbers increase Symptoms:

Headaches Weakness Fatigue Lightheadedness Shortness of breath

Diagnosis – History, physical exam, and blood testing

Treatment – Treated by addressing the cause of the disorder

Prevention – Stopping the causative factor or by doing the things that deprive the body of needed oxygen, avoiding smoking, and avoid living in high altitudes

Secondary Polycythemia(Erythrocytosis)

Common problems of the hematologic system Mononucleoisis Leukemia Lymphoma

Hodgkin’s Disease Non-Hodgkin’s Lymphoma Multiple Myeloma

Disorders of White Blood Cells

Primarily affects children and young adults Contagious by direct contact with saliva Last several weeks Epstein-Barr Virus (EBV) Fatigue, sore throat, fever, swollen lymph glands,

spleen enlargement Diagnosed by WBC count high Rest, analgesics, throat gargles, avoiding sports

activities Prevent through good oral hygiene

Mononucleoisis, the “kissing disease”

Malignant neoplasm of the blood-forming organs

High production of leukocytes, causing decrease in erythrocytes and platelets

Acute common in children; chronic common in older adults

Cause is unknown Fatigue, headache, sore throat, dyspnea, bleeding of the mucous

membranes, bone and joint paint, enlarged lymph nodes Diagnosed by clinical history and blood studies, or bone marrow

biopsy Treated by aggressive chemotherapy and a bone marrow

transplant Complete remission occurs 50% of the time No known ways to prevent

Leukemia

Neoplasms that affect lymphoid tissue Lead to impaired immunity Most common type of blood cancer

Hodgkin’s Disease Non-Hodgkin’s Lymphoma Multiple myeloma

Lymphomas

Most common lymphoma Orderly spread of disease from one lymph node group to another Cause is thought to be viral Painless enlargement of the lymph nodes in the neck, weight loss,

fever Primarily affects young adults, average age of 35 Men at higher risk than women Reed-Sternberg Diagnosed with lymph node and bone marrow biopsy Treated with radiation and chemotherapy Complete cure after 5 years of remission 93% cure rate – one of the most curable forms of cancer 20% mortality rate No known preventive measures

Hodgkin’s Disease

Not containing the Reed-Sternberg cell characteristics; more widespread than Hodgkin’s

Affects more older adults, average age of 50 years Men are affected 1.5X more often than women Cause is unknown Patients who receive/have received immuno-suppressive

medication 100X more likely chance of developing NHL Painless enlargement of lymph nodes in neck, axilla, and

inguinal areas; fever, night sweats, weight loss Diagnosed by absence of Reed-Sternberg, and lymph node and

bone marrow biopsy Combination of radiation and chemotherapy Those at increased risk – exposure to pesticides, solvents and

fertilizers Cure rate of 63% Mortality rate of 33%

Non-Hodgkin’s Lymphoma

Malignant neoplasm of plasma cells Causes weakness in the bone, leading to fractures and bone pain Cause is unknown Occurs increasingly with age, peaking in 70s, more common in men One of the most common neoplasms affecting the bone Decrease in other blood components, causing anemia, leukocytopenia and

thrombocytopenia Causes excessive blood calcium levels, tissue damage, kidney failure Diagnosed with X-ray, high calcium levels, presence of Bence Jones protein,

excessive plasma cells Treatment is poor – death is usually within 2-3 years Prevent by avoiding herbicides, petroleum products, heavy metals and radiation

Multiple Myeloma

Platelet disorders vary in terms of cause, severity, and treatment All share common symptom of bleeding Many of these disorders are inherited

Hemophilia Thrombocytopenia Disseminated Intravascular

Coagulation (DIC)

Disorders of Platelets and Clotting

Group of bleeding disorders characterized by abnormally slow clotting and long bleeding times

X-linked hereditary bleeding disorder Commonly occurs in male children

Hemophiliacs lack a blood protein that plays a role in clot formation

Symptoms: Frequent nosebleeds Bruising Prolonged bleeding in a male child (can indicate

hemophilia) Can be mild to severe

Severe cases are called hemarthrosis or bleeding into joints, which is painful, and recurrent episodes can lead to joint deformity

Hemophilia

Diagnosis – Confirmed by obtaining a detailed medical history, physical examination, and blood testing

Blood tests include measurement of clotting time and the presence of blood proteins

Treatment – No cure Aimed at prevention of injury and treatment of

symptoms Whole blood transfusions can be needed

Prevention – Because it is inherited it can only be prevented by genetic testing of possible carriers with the decision to not have children

Hemophilia cont.

Decrease in platelets that leads to an inability to clot blood normally Can be due to inadequate or abnormal platelet

production or destruction Cause is unknown

Symptoms: Abnormal bleeding in the skin, mucous

membranes, and internal organs Small hemorrhagic spots on skin; larger purplish

hemorrhagic spots Frequent nosebleeds Blood in urine

Diagnosis – Individual clinical history along with platelet count and bleeding time

Thrombocytopenia

Treatment : Avoid tissue trauma to reduce potential bleeding Administration of vitamin K to improve clotting Transfusion on platelets

Prevention- Most cases are not preventable, but there are two steps that can be taken to prevent complications Avoid taking medications that decrease platelet

aggregation or stickiness, thus making them less likely to clot. (Ex: Aspirin or Ibuprophen)

Avoid heavy drinking because alcohol slows platelet production

Thrombocytopenia cont.

Abnormal clotting followed by abnormal bleeding Blood starts to coagulate or clot throughout the entire

body Usually follows major trauma such as blood

transfusion reaction, surgery, septicemia, complicated childbirth, massive tissue destruction, shock, malignancy, or snakebite

Symptoms: Black and blue fingers and toes Large thrombus formation (can lead to life-

threatening pulmonary embolism) Oozing of blood Vomiting Blood in stool Symptoms associated with anemia

Disseminated Intravascular Coagulation

Diagnosis – History of trauma and blood studies Treatment – Identifying and treating underlying

cause can stop DIC Medications

Heparin – an anticoagulant medication to halt the formation of thrombi

Platelet administration to increase clotting ability Difficult to manage This condition is usually life-threatening and

can lead to death Often times it is referred to as “Death Is

Coming” (DIC) Prevention – Getting prompt medical treatment

for any condition that might bring on this disorder

DIC cont.

Thalassemia Hereditary hemolytic anemia Mediterranean descent Dysfunctional RBCs leading to anemia

symptoms Von Willebrand’s Disease

Hereditary, congenital bleeding disorder Deficiency in clotting and platelet function

Lymphosarcoma Similar to Hodgkin’s Disease With remission, prognosis is good

Rare Diseases

Acquired Immunodeficiency Syndrome (AIDS ) affects thousands of children in the US

1980s – HIV infection mainly acquired through blood transfusions

Today – Most all HIV infections in children are a result of maternal-fetal transfer through blood (also called perinatal transmission)

Symptoms: Many children to not experience symptoms and live a normal life for years

Diagnosis – When T-cell count drops below 200 cells per microliter

Treatment – Good nutrition, antiviral drugs, and other support therapies

Prevention- prevent mother-to-child transmission, provide pediatric treatment, and prevent infection among adolescents

Childhood Diseases:Acquired Immunodeficiency

Syndrome& Leukemia

Cancer.gov CDC.gov Human Diseases, 3rd Ed., M. Neighbors & R. Tannehill-

Jones

References