Haematological Conditions
ANAEMIA
Anaemia: most common blood Symptoms range: asymptomatic, Symptoms: fatigue, lethargy,
disorder due to reduction in RBC to severe (reduced oxygen breathlessness, fainting, pallor (pale pink
haemoglobin concentration.
Hb MCV delivery toRDW
MCH tissues) TIBC or white), palpitations, worsening of heart
(size) (colour) (angina), loss of appetite & weight loss
IRON Low Low Low High High (High Causes: blood loss from uterus or GI
DEFICIENCY transferri (hookworm, H. pylori), Menorrhagia
ANAEMIA n = low
saturation I: Microcytic, hypochromic, elliptocytes
*Investigate for with iron) (pencil cell)
Coeliac Disease
(anti-ttg, IgA) Symptoms: headache, dizziness, hair loss,
pallor, palpitations, tachycardia, fatigue
restless legs, glossitis, dysphagia, koilonychia,
stomatitis
Management: iron supplementation to
correct anaemia so treat with oral iron =
Ferrous sulphate, Fumarate (3 months)
MEGALOBLASTI Low High High ↓↓↓ Folate & VB12 deficiency
C ANAEMIA - B12: absorbed in terminal Ileum
- Folate: absorbed in Duodenum/Jejunum
*Correct B12 deficiency before Folate (!!! B before F =
otherwise neurological deficits)
Pernicious Anaemia = commonest cause of
VB12 deficiency: AI condition lack of IF
(may be due to Gastrectomy, excess
alcohol/drugs) & increased gastrin (RF’s:
T1DM, Hypothyroidism, Vitiligo) (I = anti-IF &
anti-parietal cells)
I: Megaloblasts (large erythroblasts),
macrocytic RBCs, poikilocytes (tear drop cell),
hypersegmented neutrophils
Symptoms: mild jaundice (RBC breakdown),
glossitis, angular stomatitis, peripheral
neuropathy i.e. pins & needles (VB12
deficiency)
Management:
- IM Hydroxocobalamin
- Oral Folic Acid
THALASSEMIA Low Low Low Genetic disorder that effects haemoglobin
functioning
Reduced synthesis of globin chain α, β
, thalassaemia
Imbalance of globin chains = haemolysis of
erythrocytes (RBCs)
I: Hypochromic (low MCH), poikilocytosis
M: blood transfusion (will eventually need
Iron Chelation = remove excess Iron due to
constant transfusions)
SICKLE CELL Low Autosomal Recessive; production of HbS
ANAEMIA Commonest in people from India, Middle
East, Mediterranean, West & Central Africa
I: Normocytic, normochromic, target cells,
normoblasts (pre-reticulocytes)
Symptoms: pain (vaso-occlusion), organ
damage, impaired growth development,
haemolysis, at risk of septicaemia.
Management: BM transplant
HAEMOLYTIC Low High? Increased rate of RBC destruction
ANAEMIA Increased reticulocytes (spherocytes,
elliptocytes), Heinz Bodies
Polychromatic cells and spherocytes =
immature release of RBCs
G6PD’s role is to prevent oxidative stress;
deficiency = RBCs more susceptible to
oxidative stress
Causes: Diabetic Ketoacidosis, fava beans,
stress, certain drugs
Management: blood transfusion
*Fava beans, Heinz bodies