Blood System Disorders

Red Blood Cell System Changes

• Anemia: a decrease in hemoglobin content and erythrocyte count
• True polycythemia (erythremia): an increase in hemoglobin content and erythrocyte count
• Erythrocytopathy: a disorder in erythrocyte form, such as microspherocytosis and ovalocytosis
• Hemoglobinopathies (hemoglobinoses): a disorder in hemoglobin synthesis, including thalassemia and sickle cell anemia

White Blood Cell System Changes

• Leukocytosis: an increase in the number of leukocytes in peripheral blood
• Leukopenia: a decrease in the number of leukocytes in peripheral blood
• Hemoblastosis: leukocytes acquiring qualities of a tumor cell

Platelet Changes

• Thrombocytosis: an increase in the number of platelets in peripheral blood
• Thrombocytopenia: a decrease in the number of platelets in peripheral blood
• Thrombocytopathy: a change in the quality of platelets

Blood Plasma Changes

• Hyperproteinemia: an increase in the number of plasma proteins
• Hypoproteinemia: a decrease in the number of plasma proteins
• Dysproteinemia: a change in the quality of plasma proteins

Red Blood Cell System Changes

• Anemia: a decrease in hemoglobin content and erythrocyte count
• True polycythemia (erythremia): an increase in hemoglobin content and erythrocyte count
• Erythrocytopathy: a disorder in erythrocyte form, such as microspherocytosis and ovalocytosis
• Hemoglobinopathies (hemoglobinoses): a disorder in hemoglobin synthesis, including thalassemia and sickle cell anemia

White Blood Cell System Changes

• Leukocytosis: an increase in the number of leukocytes in peripheral blood
• Leukopenia: a decrease in the number of leukocytes in peripheral blood
• Hemoblastosis: leukocytes acquiring qualities of a tumor cell

Platelet Changes

• Thrombocytosis: an increase in the number of platelets in peripheral blood
• Thrombocytopenia: a decrease in the number of platelets in peripheral blood
• Thrombocytopathy: a change in the quality of platelets

Blood Plasma Changes

• Hyperproteinemia: an increase in the number of plasma proteins
• Hypoproteinemia: a decrease in the number of plasma proteins
• Dysproteinemia: a change in the quality of plasma proteins

Changes in Red Blood Cells

• Polycythemia: an increase in the number of erythrocytes per unit volume of blood
  • Erythrocytosis: compensatory increase in erythrocytes
  • Erythremia: a tumor disease of the blood, one of the forms of chronic myelocytic leukemia

Anemia

• Decrease in the number of red blood cells
• Characteristics:
  • Anisocytosis: erythrocytes of different sizes
  • Poikilocytosis: erythrocytes of various forms
  • Polychromatophilia: erythrocytes of different coloration
  • Anisochromia: erythrocytes with different hemoglobin saturation
  • Inclusions: ring-shaped Kebota Jolly's body in erythrocytes

Classification of Anemia

• By origin:
  • Posthemorrhagic anemia: due to blood loss
  • Deficient anemia:
    • Iron deficiency
    • B12 (folic) deficiency
  • Aplastic anemia
  • Hypoplastic anemia
  • Metaplastic anemia
  • Myelotoxic anemia
  • Hemolytic anemia: due to increased destruction of red blood cells
• By course:
  • Acute anemia
  • Chronic anemia
• By morphological and functional state of the bone marrow:
  • Regenerative anemia
  • Hyporegenerative anemia
  • Aplastic anemia
  • Dysplastic anemia

Changes in Red Blood Cells

• Polycythemia: an increase in the number of erythrocytes per unit volume of blood
  • Erythrocytosis: compensatory increase in erythrocytes
  • Erythremia: a tumor disease of the blood, one of the forms of chronic myelocytic leukemia

Anemia

• Decrease in the number of red blood cells
• Characteristics:
  • Anisocytosis: erythrocytes of different sizes
  • Poikilocytosis: erythrocytes of various forms
  • Polychromatophilia: erythrocytes of different coloration
  • Anisochromia: erythrocytes with different hemoglobin saturation
  • Inclusions: ring-shaped Kebota Jolly's body in erythrocytes

Classification of Anemia

• By origin:
  • Posthemorrhagic anemia: due to blood loss
  • Deficient anemia:
    • Iron deficiency
    • B12 (folic) deficiency
  • Aplastic anemia
  • Hypoplastic anemia
  • Metaplastic anemia
  • Myelotoxic anemia
  • Hemolytic anemia: due to increased destruction of red blood cells
• By course:
  • Acute anemia
  • Chronic anemia
• By morphological and functional state of the bone marrow:
  • Regenerative anemia
  • Hyporegenerative anemia
  • Aplastic anemia
  • Dysplastic anemia

Posthemorrhagic Anemia

• Can be acute or chronic
• Acute posthemorrhagic anemia is normochromic and normocytic in the first hours after bleeding
• Restoration of plasma volume after acute blood loss causes temporary dilution of blood and decrease in hematocrit
• First sign of regeneration of red blood cells is reticulocytosis, which indicates activity of hemopoiesis

Chronic Posthemorrhagic Anemia

• Occurs with chronic hemorrhage and may be a symptom of gynecological, oncological, or gastrointestinal diseases
• Characterized by hypochromia, microcytosis, foci of regeneration in bone marrow of tubular bones, and presence of foci of extra-oesophageal hemopoiesis
• Changes caused by chronic hypoxia are also present

Hemolytic Anemia

• Characterized by shortening of life of red blood cells
• Classified based on three factors: cause of hemolysis, intra- or extravascular localization of hemolysis, and congenital or acquired character of the disease

Causes of Hemolytic Anemia

• Endoerythrocytic factors:
  • Membranopathy: hereditary spherocytosis, elliptocytosis
  • Fermentopathy: insufficiency of glucose-6-phosphate dehydrogenase, pyruvate kinase deficiency
  • Hemoglobinopathy: disorders of globin chains, reduction of synthesis of globin chains (thalassemia)
• Acquired anemia: paroxysmal nocturnal hemoglobinuria

Anemias Caused by Exoerythrocyte Factors

• Autoimmune hemolytic anemia: warm thermal antibody, cold-blooded, anemia in autoimmune diseases
• Immune hemolytic anemia: hemolytic disease of newborns, transfusion hemolytic reaction, medicinal immune hemolytic anemia, hemolysis in response to toxins and chemicals
• Mechanical damage of erythrocytes: microangiopathic anemia (erythrocyte fragmentation syndrome)
• Anemia in infectious diseases: malaria
• Hyperplenism
• Mixed species
• Dyserythropoietic anemia

Classification of Anemias

• Destruction of proliferation and differentiation of stem cells
  • Aplastic anemia
  • Aplasia of the erythroblastic sprout
  • Anemia in renal insufficiency
  • Anemia in endocrine disorders
• Destruction of proliferation and differentiation of erythroblasts
  • Disruption of DNA synthesis
    • Insufficiency or impairment of absorption of vitamin B12 and folic acid (megaloblastic anemia)
  • Destruction of the synthesis of Hb
    • Violation of heme synthesis (Fe deficiency)
    • Violation of globin synthesis (thalassemia)
  • Unknown or mixed mechanisms
    • Anemia due to a violation of the metabolism of Fe (anemia sideroblast, with chronic diseases, with myelodysplasia)

Characteristics of Megaloblastic Anemia

• Anisocytosis: macrocytes and megalocytes predominate
• Poikilocytosis: erythrocytes in the form of an oval, racket, crescent
• Megalocytes with remnants of the nucleus (Kebot's rings)
• Erythrocytes are brighter in color
• Atrophy of the gastric mucosa in pernicious Addison-Birmer anemia
• The mucous membrane of the stomach is thinned, there are only single glandular structures
• Atrophic gastritis precedes the development of gastric cancer (with pernicious anemia, stomach cancer develops 8 times more often)

Anemias Caused by Exoerythrocyte Factors

• Autoimmune hemolytic anemia: warm thermal antibody, cold-blooded, anemia in autoimmune diseases
• Immune hemolytic anemia: hemolytic disease of newborns, transfusion hemolytic reaction, medicinal immune hemolytic anemia, hemolysis in response to toxins and chemicals
• Mechanical damage of erythrocytes: microangiopathic anemia (erythrocyte fragmentation syndrome)
• Anemia in infectious diseases: malaria
• Hyperplenism
• Mixed species
• Dyserythropoietic anemia

Classification of Anemias

• Destruction of proliferation and differentiation of stem cells
  • Aplastic anemia
  • Aplasia of the erythroblastic sprout
  • Anemia in renal insufficiency
  • Anemia in endocrine disorders
• Destruction of proliferation and differentiation of erythroblasts
  • Disruption of DNA synthesis
    • Insufficiency or impairment of absorption of vitamin B12 and folic acid (megaloblastic anemia)
  • Destruction of the synthesis of Hb
    • Violation of heme synthesis (Fe deficiency)
    • Violation of globin synthesis (thalassemia)
  • Unknown or mixed mechanisms
    • Anemia due to a violation of the metabolism of Fe (anemia sideroblast, with chronic diseases, with myelodysplasia)

Characteristics of Megaloblastic Anemia

• Anisocytosis: macrocytes and megalocytes predominate
• Poikilocytosis: erythrocytes in the form of an oval, racket, crescent
• Megalocytes with remnants of the nucleus (Kebot's rings)
• Erythrocytes are brighter in color
• Atrophy of the gastric mucosa in pernicious Addison-Birmer anemia
• The mucous membrane of the stomach is thinned, there are only single glandular structures
• Atrophic gastritis precedes the development of gastric cancer (with pernicious anemia, stomach cancer develops 8 times more often)