Overview of Anemia PDF 2024-2025

Overview of Anemia Dr. Mohamed Nasr lecturer of hematology and Internal medicine Ain Shams University 2024-2025  Learning Objectives What is anemia What are symptoms and signs of anemia What is classification and different types of anemia What ar...

Overview of Anemia Dr. Mohamed Nasr lecturer of hematology and Internal medicine Ain Shams University 2024-2025  Learning Objectives What is anemia What are symptoms and signs of anemia What is classification and different types of anemia What are causes of different types of anemia  Definition : Anemia: is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood Hemoglobin less than 13.5g/dl and / or Hematocrit less than 41% in men And less than 12g/dl in women and / or Hematocrit less than 36%  Classification of Anemia Causes Decreased production Blood loss Hemolysis Red cell size Microcytic (MCV 100 µ3): MorphologylMorphologyClassificationassificat ion Microcytic (MCV 100 µ3): 1. B12 or folate deficiency ( megaloblastic) 2. (Non – megaloblastic but with macrocytes ) Hypothyroidism Liver disease bone marrow ( myelodysplasia ) Alcohol intake General symptoms General signs (regardless type of anemia) 1. Pallor ( in mucus membrane like inner part of lips and conjunctiva, palmar creases) 2. Palpitation (symptom ) Tachycardia (sign ) i.e. increase heart rate 3. Postural hypotension Signs of anemia Microcytic Hypochromic Anemia: Iron deficiency Thalassemia Lead toxicity Sideroblastic anemia Anemia of chronic disease How to Differentiate?????? Fe study  Iron Deficiency Anemia A world-wide problem 3% of toddlers age 1-2 years 2-5% of women of child bearing age Most common type of microcytic anemia (80%) Features of Iron Deficiency Anemia General symptoms and sign plus 1. Pica - craving of nonfood substancese.g., dirt, clay, laundry starch 2. Glossitis - smooth tongue 3. angular stomatitis - cracking of corners of mouth 4. Koilonychia - thin, brittle, spoon-shaped fingernails sign of Iron Deficiency Anemia Treatment of iron def. anemia Remember Anemia is a symptom not a disease So when we treat any type of anemia we must know the cause and treat it Causes of Iron Deficiency anemia Increased iron requirements Blood loss Gastrointestinal tract Genitourinary tract Blood donation Pregnancy and lactation Inadequate iron supply Insufficient dietary iron Impaired iron absorption Gastric surgery Intestinal malabsorption Celiac disease Treatment with Oral Iron: General Principles Ferrous salts are absorbed better than ferric All ferrous salts are absorbed to the same extent Ascorbic acid increases absorption Iron is absorbed best on an empty stomach Iron should not be given with antacids Duration of treatment ?????????? Use of Parenteral Iron Indications Malabsorption Rapid increase of store High rate of blood loss Toxicity/noncompliance with oral iron Agents available Iron dextran (total dose replacement; 1/300 anaphylaxis) Iron polysaccharide (125 mg/d maximum; ~1/1000 anaphylaxis) Dose iron deficit (mg) = weight (kg) x (14 - Hgb) x (2.145) +(500 if you need to full store) Response Maximal increase in hemoglobin synthesis Rapid increase in iron stores When to transfuse packed RBCS to patients with fe def, anemia ??????? Depend on : 1-rate of loss 2-age of patients 3-surgery 4-comorbity 5-severity of symptoms Thalassemia: Impaired globin gene prouction Decreased production of normal globin chains:  thalassemia: deficiency of  gene(s)  thalassemia: deficiency of  gene(s)  Beta Thalassemia Syndrome Genotype Hgb (g/dl) Minor (Trait) /+ or /° 10-13 Intermedia +/+ 7-10 Major (Cooleys) +/° or °/°