Anemia

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Anemia classification

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Morfologic criteria:
-According to MCV: (80 – 95 fl)
-micro-, normo-, macrocytic
-According to MCH: (27-32 pg)
normochrome, hypochrome
-According to no of reticulocytes: (0,7 – 2,8 %)
anaemia with lowered, normal or incresed no of reticulocytes

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MICROCYTIC ANAEMIA

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Iron deficiency anaemia
Chronic disease anaemia
Thalasemia
Sideroblastic anaemia

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MACROCYTIC ANAEMIA

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Megaloblastic anaemia:
lack of B12, folic acid, myelodysplastic syndrome (MDS)

Macrocytic non-megaloblaste anaemia (usually secondary)

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NORMOCYTIC ANAEMIA

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Primar impairment of blood marrow:
aplastic anaemia, MDS, paroxysmal nocturnal hemoglobinuria (PNH), myelofibrosis.

Secondary impairment of blood marrow :
infiltration, infection, endocrinological and systemic diseases, ACD

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ANAEMIA WITH RETICULOSIS

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- Haemolytic aneamia corpuscular
- Haemolytic anaemia extracorpuscular (imunne and non-immune based)

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Alpha-thalassemia

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1) - α/ α α = silent carrier
2) - α/- α , - - / α α = carrier (mikrocytosis, erythrocytosis):
= Thalassemia minor
3) - - / - α = HbH (β4) (splenomegalia, mikrocytosis, bones)
4) - - / - - = hydrops fetalis, sy Hb Bart´s (γ4)

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Where do we find Heinz bodies?

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Target cells in HbH disease

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Beta-thalassemia minor

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(β+/ β, β0/ β)
Mikrocytosis, anaemia, erythrocytosis

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Beta-thalassemia intermedia

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(β+/ β+, β0/ β+)

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Beta-thalassemia major

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(β0/ β0, β+/ β+)
Severe anemia, anisopoikilocytosis, affected ERY, HbF, hepatosplenomegalia, bone deformities, permanent transfusion therapy, Fe overload, Tx, splenectomia, (HU (??))