anemia pathophysiology by francis oliveros, bsn 4
TRANSCRIPT
Idiopathic Autoimmunity
Predisposing Risk Factors
-Age-Gender-Race-Lifestyle Choices
Precipitating Risk factors
-Treatment with high dose radiation or chemotherapy-Exposure to toxic chemicals-Drug induced(Chloramphenicol)-Autoimmune blood disorders-Pregnancy (Rare)-Genetic
Activation of cytotoxic T cells Mutation in genes responsible for telomere repair complex
Targets own marrow stem cells
Depletion and damage of hematopoietic stem cells
Reduction in bone marrow progenitorsDepression or cessation of activity of all blood producing elements
Deficiency in the repair capacity of
hematopoietic tissue.
Depletion and damage of hematopoietic stem cells
Decreased Normochromic, normocyric RBcs
Pancytopenia
Normocytic Anemia Aplastic Anemia
Clinical manifestations:
Fatigue Shortness of breath with exertion Rapid or irregular heart rate Pale skin Frequent or prolonged infections Unexplained or easy bruising Nosebleeds and bleeding gums Prolonged bleeding from cuts Skin rash Dizziness Headache
Diagnostic tests:
1. Bone marrow aspirate and biopsy: to rule out other causes of pancytopenia (i.e. neoplastic infiltration or significant myelofibrosis).
2. History of iatrogenic exposure to cytotoxic chemotherapy: can cause transient bone marrow suppression
3. X-rays, computed tomography (CT) scans, or ultrasound imaging tests: enlarged lymph nodes (sign of lymphoma), kidneys and bones in arms and hands (abnormal in Fanconi anemia)
4. Chest X-ray: infections5. Liver tests: liver diseases6. Viral studies: viral infections7. Vitamin B12 and folate levels: vitamin deficiency8. Blood tests for paroxysmal nocturnal hemoglobinuria9. Test for antibodies: immune competency
Medications/ Treatment:-Blood transfusions-Immunosuppressant-Bone marrow stimulants-antibiotics, antiviral
Surgical Management:
-Bone marrow transplant
Iron level insufficiency in the body
Impaired/insufficient Hemoglobin synthesis in the red bone marrow
Red Cell release insufficiency
Abnormal Heme Synthesis
Predisposing Risk Factors
-Age-Gender-Race-Lifestyle Choices
Precipitating Risk factors
-Low iron dietary intake-Gynaecologic abnormalities-Chronic bleeding-Pregnancy-Mal absorption Problems
Chronic Bleeding(Due to chronic conditions)
Prolonged/ Over activation of response to initiate Erythropoiesis
Iron store depletion
Formation of Hypochromic, small, non functional RBCs
Iron deficiency anemia
Microcytic Anemia
Clinical Manifestations:
Weakness Loss of appetite Pale lips Sore mouth Pale eyelids Lightheadedness Headache Early symptoms are mild Shortness of breath after exercise Concentration problems Sleeping problems Rapid heartbeat Irregular heartbeat Chest pain Dizziness Impaired cognitive ability Cold skin Fatigue Tiredness Mild early symptoms Pallor Anemia Concave nails Brittle nails Husky voice Tongue inflammation Difficulty swallowing Low levels of iron in blood Low levels of haemoglobin Reduced red blood cell count Pica Persistent urge to consume ice Persistent urge to consume clay Asymptomatic in mild cases Fingernail abnormalities
Laboratory diagnosis
1. Serum ferritin, an iron storage protein, is low
2. Decreased serum iron, increased iron binding capacity, < 16% saturation
3. Microcytosis, hypochromia, anisocytosis, poikilocytosis
4. Increased red cell distribution width(RDW)
5. Decreased absolute reticulocyte count with inadequate response to anemia.
6. Normal WBCs 7. thrombocytosis8. Decreased iron stains in the bone marrow