2. Normal Erythropoiesis
Kidney Bone marrow Multi-potent
stem cell
Epo
mRNA Erythroid
stem cell
Epo
Oxygen
sensor
3-4
days
Blood vessel
Peripheral
blood
RBC survival
100-120 days
3.
4.
5.
6.
7. Anemia
âą Understanding anemia
â Disease - to be treated on its own merits
â Condition - a secondary manifestation of
another disease
â Symptoms depend on severity/acuity
âą Causes
â Decreased production
â Blood loss
â Hemolysis
8. Laboratory Evaluation of Anemia
âą Complete blood count
âą Peripheral smear
âą Reticulocyte count
â Relative reticulocyte count
⊠Percent of all RBC (normal 0.8%â1.5%)
â Absolute reticulocyte count
⊠Relative reticulocyte count x RBC count
⊠Normal 50,000â75,000/”l
⊠Examples: 6
1.1% x 4.96 x10 = 55,000/ïl
6
12.2% x 2.05 x10 = 250,000/ïl
9. Classification of Anemia Based on
RBC Kinetics and Size
MCV
Microcytic Normocytic Macrocytic
Retic Low Common Common Common
count
High Uncommon Common Uncommon
10. Microcytic Hypochromic Anemia:
Diagnosis
âą Mild (MCV > 70 fl) âą Severe (MCV < 70 )
â Iron deficiency â Iron deficiency
â Thalassemia â Thalassemia
â Lead toxicity
â Sideroblastic anemia
â Anemia of chronic
disease