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Samenvatting Schema hoofdstuk 2: oppuntstelling anemie
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Dit is een schema van hoofdstuk 2: oppuntstelling anemie
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Anemie = tekort aan Hb in perifeer bloedMCV
nl ↑
↓
Hypochrome microcytaire anemie Normochrome normocytaire anemie Macrocytaire anemie
Perifeer bloeduitstrijkje
Serumijzer concentratie Reticulocyten aantal
BM-onderzoek
Reticulocytose
↓ nl/↑ ↑ ↑ ↓/nl
Gestoord ijzermetabolisme Gestoorde globinesynthese Gestoorde porfyrine- en heemsynthese BM probeert te Per definitie abnormaal, want
compenseren! BM compenseert niet. Megaloblastisch BM Normoblastisch BM
Eerst uitsluiten nierinsufficiëntie
TIBC, ferritine & BM Hb-elektroforese TIBC, ferritine & BM en endocrinopathieën!
HBF & HBA2 gehalte
Reticulocyten aantal
BM-onderzoek
Ijzermetabolisme studies
TIBC: ↑ TIBC: ↓ TIBC: nl (serumijzer, ferritine, BM)
Ferritine: ↓ Ferritine: ↑ Ferritine: ↑ ↑ ↓/nl
BM-reserves: ↓ BM-reserves: ↑ BM: ringsideroblasten
Serumijzer: ↓ Serumijzer: ↑
Bloeding Hemolyse VitB12/folaat-deficiëntie Bloeding Leverziekten
Ijzer deficiëntie Ijzer reutilisatie Thalassemie Sideroblastische
(=ferriprieve stoornis anemie Stoornissen Hemolyse Alcoholisme
anemie) (=anemie van de
vitB12/folaat-
chron.ziekte) --> Congenitaal
Beginnende BM a/hypoplasie metabolisme Myelodysplastische
--> Bloedverlies --> Verworven
↓haptoglobine ijzerdeficiëntie
--> Gebrekkig dieet --> Infecties syndromen
--> Malapsorptie Coombs-test/DAT Myeloftyse (leukemie, Defecten DNA-synthese
--> Chron.inflammatie
IJzer reutilisatie- myeloom, myelofibrose,
--> Neoplasie
meta’s) Hypothyroïdie
stoornissen (ikv
DAT posi DAT nega chron.ziekte)
Gemaskeerde Myeloftyse (leukemie,
myeloom, myelofibrose,
megaloblastische meta’s)
anemie
Immune hemolytische anemie Enzymopathieën
(auto/allo/iso-immuun) Membranopathieën Myeolodysplastische
Hemoglobinopathieën syndromen
Infecties (bvb malaria)
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