Anemia - University of California, Los Angeles
Anemia
|Types of anemia |Hypoproliferative anemia |Ineffective hematopoiesis |Compensatory proliferative erythropoiesis |
|Etiology |High epo: |Disordered cellular DNA synthesis |Extramedullary cause of early erythrocyte |
| |Fe deficiency |B12 metabolism |destruction (hemolytic anemia) |
| |Blockade of heme synthesis (Pb, INH, or |Malabsorption of B12 due to pernicious anemia, |Intravascular causes: |
| |pyrazinamide, sideroblastic anemia—congenital or |gastrectomy, absent intrinsic factor |Vascular disorders |
| |acquired) |Intestinal malabsorption due to ileal resection, |Physical agents: burns, trauma (march |
| |Anemia of chronic disease |regional ileitis, infiltrative intestinal disease |hemoglobinuria, valvular heart disease, prosthetic |
| |Myelophthisic disorders |Folate deficiency |valves) |
| |Solid tumors, leukemia, lymphoma |Inadequate intake |DIC |
| |Intracellular infections: TB, histoplasmosis, |Malabsoption |TTP/HUS – bacterial or viral cause. Endothelial |
| |sarcoidosis |Alcohol |injury triggers platelet plug |
| |Storage dz: Gaucher’s |DHFR inhibitor |Vasculitis |
| |Osteopetrosis, myelofibrosis, myeloma. |Cytotoxic chemotherapy, AZT, hypothyroidism, purine |Plasma Factors |
| |Aplastic anemia |and pyrimidine antagonists, inborn errors of nucleic|Snake/insect venom |
| |Low epo: |acid metabolism |C. perfringens toxin |
| |Chronic renal disease |Myelodysplasia |Chemical Agents |
| |Cancer | |Benzene |
| |Rheumatoid arthritis | |Hypotonic soln |
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| | | |Extravascular hemolysis |
| | | |Membranopathy |
| | | |Congenital (hereditary spherocytosis, |
| | | |elliptocytosis, poikylocytosis) |
| | | |Acquired (lymphoreticular neoplasia, autoimmune dz, |
| | | |drugs) |
| | | |Enzymopathy |
| | | |G6PD |
| | | |Pyruvate Kinase |
| | | |Hemoglobinopathy |
| | | |Hgb SS |
| | | |Hgb SC |
|Peripheral blood smear |Reticulocytopenia, immature wbc/rbc, tear drop cells|Reticulocytopenia |Reticulocytosis |
|Bone Marrow |hypocellularity |Hypercellularity |Hypercellularity |
| | |Intramedullary hemolysis | |
| | |Megaloblastic features (hypersegmented PMNs and | |
| | |macrocytosis) | |
| |Hypochromic |Oval macrocytic |Variable |
| |Normo-/microcytic | | |
|LDH |Low |High (intramedullary hemolysis) |High |
|Erythropoietin |Variable |High |High |
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