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Classification of anaemia

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Anaemia is a medical condition defined as a reduction in red blood cells ,hemoglobin and or hematocrit according to gender and age of individual.

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Classification of anaemia

  1. 1. Classification of anaemia Presented by Sahar Gamal Elbager M.Sc in Haematology UMST
  2. 2. Objective By the end of this course, the student should be know the: 1. Definition of anaemia 2.Symptoms and signs of anaemia 3.Physiologic compensation for anaemia 4.Classification of anaemia 09/22/17 Sahar Gamal Elbager 2
  3. 3. Definition of anaemia Anaemia is a medical condition defined as a reduction in red blood cells ,hemoglobin and or hematocrit according to gender and age of individual. Sahar Gamal Elbager09/22/17 3
  4. 4. General symptoms and signs • Easy fatigue and loss of energy • Tachycardia rapid heart beat. • Shortness of breath. • Difficulty concentrating • Dizziness • Pale skin Sahar Gamal Elbager09/22/17 4
  5. 5. Physiologic compensation for anaemia 1- Decreased hemoglobin oxygen affinity: Increase the production of 2,3-DPG which 2- Redistribution of blood flow to vital organ: eg: brain and liver. 3- Increased cardiac output: The heart can respond to tissue hypoxia by increased cardiac output. Sahar Gamal Elbager09/22/17 5
  6. 6. Classification of anaemia
  7. 7. Classification of anaemia • Morphological classification. • Etiological classification. 09/22/17 Sahar Gamal Elbager 7
  8. 8. Morphological classification • Which based on red cell appearance of STD blood film & red cell indices calculated from Hb , PCV & RBCS count values: I. Normocytic normochromic anaemias II. Macrocytic anaemias III. Microcytic hypochromic anaemias. Sahar Gamal Elbager09/22/17 8
  9. 9. Normocytic normochromic anaemias MCV : normal (80-95fL) MCH : normal (≥27pg) These include: 1. ACD. 2. Acute hemorrhage. 3. Hemolytic Anaemia. 4. A plastic anaemia. Sahar Gamal Elbager09/22/17 9
  10. 10. Microcytic hypochromic anaemia MCV <80 Fl MCH <27 Pg These include: 1. Iron deficiency anaemia. 2. Thalassemia. 3. Sideroblastic anaemia. 4. Lead poisoning. 5. ACD. (rare cases)Sahar Gamal Elbager09/22/17 10
  11. 11. Macrocytic anaemias MCV : >80 MCH : >27 These include: 1. Megaloblastic anaemia. 2. Alcoholism 3. Liver disease. 4. Hypothyroidism. Sahar Gamal Elbager09/22/17 11
  12. 12. Etiological classification I.I. Impaired red cell production (bone marrow defect).Impaired red cell production (bone marrow defect). II.II. Excessive red cell destruction (hemolytic anaemia)Excessive red cell destruction (hemolytic anaemia) III.III. Blood loss anaemiaBlood loss anaemia Sahar Gamal Elbager09/22/17 12
  13. 13. Etiological classification I.I. IMPAIRED RED CELL PRODUCTIONIMPAIRED RED CELL PRODUCTION 1. Inadequate supply of nutrients essential for erythropoiesis: – Iron deficiency – Vitamin b-12 deficiency – Folic acid deficiency – Protein malnutrition 5. Reduction in erythropoietin production: – Chronic renal disease Sahar Gamal Elbager09/22/17 13
  14. 14. Etiological classification I.I. IMPAIRED RED CELL PRODUCTIONIMPAIRED RED CELL PRODUCTION 4. Infiltration of bone marrow by neoplastic cell: – Leukemia – Lymphoma – Myeloproliferative Disorder • Polycythemia • Essential Thrombocythemia • Chronic Myeloid Leukemia • Myelofibrosis – Myeloma – Myelodysplastic Disorders Sahar Gamal Elbager09/22/17 14
  15. 15. Etiological classification I.I. IMPAIRED RED CELL PRODUCTIONIMPAIRED RED CELL PRODUCTION 5. Chronic disorders: – Infection – Connective tissue disorders – Inflammatory disorders – Disseminated malignancy Sahar Gamal Elbager09/22/17 15
  16. 16. Etiological classification II. Exessive red cell destruction (haemolytic anaemia) i. Due to intrinsic defects in RBCs a.Congenital 1.Membrane defects: i. Hereditary spherocytosis ii. Hereditary elliptocytosis 2.Enzyme defects : i. G6PD deficiency ii.Pyruvate kinase deficiency Sahar Gamal Elbager09/22/17 16
  17. 17. Etiological classification II. Exessive red cell destruction (haemolytic anaemia) i. Due to intrinsic defects in RBCs a. Congenital 3. Haemoglobin defects: i. Haemoglobinopathies: Sickle cell anaemia ii.Thalasaemia: α thalasaemia and β thalasaemia b. Acquired Paroxysmal Nocturnal Haemoglobinuria (PNH) Sahar Gamal Elbager09/22/17 17
  18. 18. Etiological classification II. Exessive red cell destruction (haemolytic anaemia) i. Due to extrinsic defects in RBCs a. Immune mechanisms 1. Autoimmune acquried haemolytic anaemia ◊ ◊warm antibody ◊ cold antibody 2. Haemolytic Disease of New Born (HDN) 3. Drug induced haemolytic anaemia b. Non immune mechanisms 1. Cardiac haemolytic anaemia 2. Microangiopathic haemolytic anaemia 3. March haemolytic anaemia Sahar Gamal Elbager09/22/17 18
  19. 19. Etiological classification II. Exessive red cell destruction (haemolytic anaemia) i. Due to extrinsic defects in RBCs c. Miscellaneous 1. Due to action of certain drugs, chemical or physical agents 2. Due to parasitic infection e.G. Malaria ,hookworm….Etc 3. Due to burns. Sahar Gamal Elbager09/22/17 19
  20. 20. Etiological classification III. BLOOD LOSS ANAEMIA a. Overt blood loss • Surgery • Accident • Menorrhagia • Recurrent bleeding from any other site a. Occult blood loss • Gi bleeding • Genti-urinary bleeding Sahar Gamal Elbager09/22/17 20
  21. 21. Thank you

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