Reduced haemoglobin level below the reference level for the age and sex of the individual
CAUSES OF ANAEMIA
« Nutritional
« Reduced absorption
« Blood loss
« Haemolysis
« Bone marrow suppression Chronic infection
« Other chronic diseases
CLINICAL FEATURES OF ANAEMIA
« Fatigue
« Headache
« Faintness
« Breathlessness
« Angina
« Intermittent claudication
« Palpitations
« May be asymptomatic
SIGNS
1. Pallor
2. Tachycardia
3. Bounding pulse
4. Systolic flow murmur
5. Evidence of cardiac failure
Rarely, Papilloedema,
Retinal haemorrhages
SPECIFIC SIGNS
Signs of Nutritional deficiency +
Koilonychia (Fe Deficiency)
Bone deformities (Thalassaemia)
Leg ulcers (Sickle cell disease)
Lymphadenopathy/Hepatosplenomegal
(Myeloproliferative/lymphoproliferative disorders)
Telengiectasia
(Hereditary haemorrhagic telengiectasia)
INVESTIGATIONS
ü Hb level
ü WBC count
ü Platelet count
ü Reticulocyte count (Indicates marrow activity)
ü Blood picture (indicated probable aetiology)
ü Bone marrow
TYPES OF ANAEMIA
According to the blood picture,
HYPOCHROMIC MICROCYTIC ANAEMIA
ü Iron deficiency anaemia
ü Thalassaemia
NORMOCHROMIC NORMOCHROMIC ANAEMIA
ü Anaemia of chronic disease
MACROCYTIC ANAEMIA
ü Vit B12, Folate deficiency
DIAMORPHIC BLOOD PICTURE
ü Mixed deficiency or following treatment
IRON DEFICIENCY ANAEMIA
(Hypochromic microcytic anaemia)
CAUSES
« Blood loss
« Decreased absorption
« Poor intake
« Increased demand
(Growth, Pregnancy)
HISTORY
« Detailed dietary history
« Menstrual history
« Evidence of chronic infection
« Possibility of GI haemorrhages
« Drugs – NSAIDs
CLINICAL FEATURES
FEATURES OF ANAEMIA +
¦Brittle nails
¦Koilonychia (spoon shaped nails)
¦Atrophy of the papillae of the tongue
¦Angular stomatitis
¦Brittle hair
¦Dysphagia and Glossitis
¦(Plummer vinson/kelly patterson)
INVESTIGATIONS
· Blood counts and Red Cell Indices
MCV <80 fl Microcytic
MCH <27 pg Hypochromic
· Blood picture
Hypochromic microcytic with poikylocytosis (variation in shape) and anisocytosis (variation in size)
· Serum Fe â
· Total iron binding capacity (TIBC) á
· Transferrin
saturated
Low serum ferritin confirms the diagnosis
Normal level : Male = 30-300u
Female = 15-200u
Bone marrow is not needed to diagnose iron deficiency anaemia
Other causes of hypochromic microcytic anaemia
· Thalassaemia
· Anaemia of chronic diseases
Treatment
· Find out and treat the underlying cause
· Oral iron therapy
(ferrous sulphate 200mg tds)
No comments:
Post a Comment