|
v
Normal
ranges of RBC indices:
|
|
♂
|
♀
|
|
Hb
(g/dL)
|
15.5
± 2
|
13.5
± 2
|
|
Hct
(PCV) %
|
46
± 6
|
42
± 6
|
|
MCV
(fL)
|
80
– 95
|
|
|
MCHC
(g/dL)
|
30
– 35
|
|
MCH
(pg)
|
27
– 37
|
v
Definition:
↓ Hb.
·
Anemia is NOT a
disease, rather it’s a sign of a disease.
·
N.B.
↓ plasma volume may mask
anemia / even cause polycythemia.
Conversely, ↑ plasma volume
(associated with splenomegaly / pregnancy) à
anemia even with normal circulating RBC & Hb mass.
·
N.B.
After acute major blood loss, anemia is NOT immediately
apparent since total blood volume ↓.
·
N.B.
Anemia is associated with ↑ 2,3-DPG in RBCs à
O2 is delivered more readily to tissues.
Symptoms:
Dyspnea
(esp. on exercise), weakness,
lethargy, palpitation,
headache.
Signs:
General:
Pallor of mucous membrane.
Specific:
Koilonychia
à
Fe+ def. anemia
Jaundice
à
Hemolytic / Megaloblastic anemia
Leg ulcers
à
SCA.
Bone
deformities à
Thalass. Major
N.B.
Retics (N = 0.5 – 2 %) count:
o
↑
in hemolytic anemia & after Fe+ therapy.
o
Remains ↑
until Hb returns to normal levels.
N.B.
Ineffective Erythropoiesis = Intramedullary Hemolysis
·
10 – 15 % of
erythropoiesis.
·
↑↑ in
chronic anemia
·
↑
serum unconj. bilirubin.
·
↑ LDH.
Fig.
Diagrammatic representation of the relative proportions of
marrow erythroblastic activity, circulating RBC mass, RBC lifespan.
written
by:
Khalid Bin Yaroof. FMHS, UAE University.
| 
