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Common Red Cell Appearances And Their Causes

  1. Microcytosis (Reduced average cell size, MCV < 76 fl)
    1. Iron deficiency
    2. Sideroblastic anaemia
    3. Thalassemia
    4. Lead toxicity
    5. AOCD(+/-)
  2. Macrocytosis (increased average cell size, MCV > 100 fl)
    1. Vitamin B12/Folate deficiency
    2. Hypothyroidism, Thiamine deficiency
    3. Liver disease, alcohol
    4. Drugs (e.g Zidovudine)
  3. Normocytic with high reticulocyte count
    1. Blood Loss
    2. DIC
    3. Hemolytic anemia
    4. Sickle cell anemia
    5. Hemangioma
  4. Normocytic with low reticulocyte count
    1. RBC aplasia (Diamond Black fan syndrome, Parvo virus)
    2. Malignancy
    3. Fanconi Anemia
    4. AOCD
    5. CRF
  5. Target cells (Central area of haemoglobinisation)
    1. Liver disease
    2. Post – splenectomy
    3. Thalassanemia
    4. Hemoglobin C disease
  6. Spherocytes (dense cells, no area of central pallor)
    1. Autoimmune hemolysis
    2. Hereditary spherocytosis
    3. Post – splenectomy
  7. Red cell fragments Micro angiopathic hemolytic anemia.
    1. DIC
    2. HUS
    3. TTP
  8. Nucleated Red` blood cells (Normoblasts)
    1. Marrow infiltration
    2. Myelofibrosis
    3. Severe hemolysis
    4. Acute hemorrhage
  9. Howell – Jolly bodies (small round nuclear remnants)
    1. Hyposplenism
    2. Dyshemopoiesis
    3. Post – splenectomy
  10. Polychromasia (young red cells – reticulocytes present)
    1. Hemolysis
    2. Acute hemorrhage
    3. Increased Red cell turnover
  11. Basophilic stippling (abnormal ribosomes appear as blue dots)
    1. Dyshemopoiesis
    2. Lead poisoning .
  12. Lead poisoning can Causes
    1. Sideroblastic anemia
    2. Hemolysis
    3. Punctate Basophilia

Inclusion Bodies

 

 

Anemia

Definition: Anemia may be defined as a state in which the blood hemoglobin level is below the normal range for the patient’s age and sex

 

(Males < 13gm/dL; females < 12 gm/dL. (Pregnancy <11 gm%) (Ref. Park 20th ed., Page 539, Table 14,)

 

Hemoglobin at birth is about 20 gm/dl and it gets reduced to 10 gm/dl at 3 months of age.

 

Important Points: Symptoms and Signs

  1. Fatigue
  2. breathlessness on exertion
  3. palpitation
  4. angina
  5. tachycardia
  6. cardiac dilatation
  7. systolic flow murmurs
  8. edema




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