Classification of Anaemia: Comparative Analysis for Case Study

Aspect Class Etiology Iron Deficiency Thalassemia Anaemia ( and ) Hypochromic Microcytic Blood loss Mutation in globin High demand chain gene either Malabsorption in chromosome 16 Parasitic infection () or 11 () Malnutrition RBC Destruction None important (major, minor) (silent carrier, minor, HbH and hydrops fetalis) Depletion of iron Unpaired chain stores , normal precipitate in developing RBC developing cells Exhausting iron Damage to RBCs storage pool surface, removal Signs of anaemia by macrophages Fatigue Severe anaemia in Pallor childhood Breath shortness Frontal bossing Koilonychia Jaundice Glossitis Enlargement of Pica (Cravings) liver and spleen Pencil cells Target cells Elongated cells Basophilic stip. Iron studies (Low ferritin, TS, iron) Iron supplement Transfusion Desferrioxamine Hb electrophoresis Supravital stains Transfusion Desferrioxamine Hydroxyurea Hereditary G6PD Enzyme Sickle Cell Disease Spherocytosis Deficiency Normochromic Normocytic (Haemolytic) Membrane defect Point mutation in X gene mutation, th Defect in band 3, chromosome glu val at 6 ankyrin, spectrin Inherited X-linked Structural change and protein 4.2 recessive in RBC shape Fava beans, drugs None important None important Sickle cell trait Sickle cell disease Vitamin B12 Deficiency Macrocytic Inadequate intake Increased need Failed to separate from haptocorrin Lack of intrinsic f. Folate defect

Divisions

Mechanism

Loss of support in lipid membrane RBC rigid & survival in spleen

Symptoms

Classic anaemia Splenomegaly Jaundice Megaloblastic crisis (folic acid)

Cannot maintain glutathione(GSSG) as reduced GSH Leads to oxidative damage of RBC Heinz body deposit Acute hemolytic anaemia Neonatal jaundice Classic anaemia

X O2, RBC less soluble, sickling Blood viscous Blood flow prolong exposure Vaso-occlusion Loss of spleenic function Vaso-occlusive Classic signs of anaemia Crescent shaped sickle cells Hb electrophoresis Sickling test Transfusion Hydroxyurea BM transplantation

Folate trapping Abnormal DNA homocysteine SAM Methylmalonic aciduria (neuro) Memory loss Loss of balance Numbness in toes and fingers Classic anaemia

Blood film

Spherocytes

Bite cells Blister cells Fluorescent spot PCR / Molecular Splenectomy Transfusion BM transplantation

Lab Finding Treatment

Spectrin IA Hemolysis test Splenectomy Transfusion

Oval macrocytes Hypersegmented neutrophils Schilling test Vitamin B12 IM / Nasal B12