Investigations in diagnosing type and causes of anaemia
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Investigations in diagnosing type and causes of anaemia
- 2. 1. Full blood count 2. Hb 3. Blood picture 4. Bone marrow investigations 5. Reticulocyte count 6. Serum iron studies 7. Eletrophoresis 8. Coombs test 9. Osmotic fragility test 10.ESR 11.Serum creatinine levels
- 5. WHO recommended Haemoglobin levels to diagnose anaemia at sea level (g/l)± Non -Anaemia* Children 6 - 59 months of age 110 or higher Mild 100-109 Anaemia* Moderate 70-99 Children 5 - 11 years of age 115 or higher 110-114 80-109 lower than 80 Children 12 - 14 years of age 120 or higher 110-119 80-109 lower than 80 Non-pregnant women (15 years of age and above) 120 or higher 110-119 80-109 lower than 80 Pregnant women 110 or higher 100-109 70-99 lower than 70 Men (15 years of age and above)130 or higher 110-129 80-109 lower than 80 Severe lower than 70
- 6. Summary for anaemic heamoglobin concentrations •Male •Female •Infant /children up to 12 yr •Pregnant female < 13 mg/dl <12 mg/dl <11 mg/dl < 11 mg/dl
- 7. Normocytic Macrocytic Microcytic 80-96 fL >96 fL < 80 fL
- 16. Iron deficiency anaemia blood picture Normal blood picture
- 17. SERUM IRON LEVELS TOTAL IRON BINDING CAPACITY SERUM FERRITIN LEVEL TRANSFERRIN SATURATION Significantly decrease Increased Decreased Significantly decrease
- 20. Sideroblastic anaemia Normal blood picture
- 22. Low MCV Blood film Serum iron High Bone marrow iron Sideroblastic anaemia Normal/High Low Hb F/A2 Ferritin Thalassaemia Iron deficiency anaemia
- 24. Macrocytic anaemia Non megaloblastic anaemia Megaloblastic anaemia Hypothyroidism Vit B12 dificiency anaemia Folate dificiency anaemia Aplastic anaemia Chonic liver disaese Alcoholic dugs
- 26. Bone marrow- normal Bone marrow –macrocytic anemia
- 27. Vit B12 Dificiency aneamia We can do further investigations to confirm the cause Intrinsic factor antibody test Schilling test Upper gastro intestinal endoscopy History taken Folate Dificiency anaemia Red cell folate test Serum folate test
- 28. Some of main causes are Excess alcohol Liver disease Aplastic anaemia Hypothyroidism Drugs This causes can confirmed by History taken of the patient
- 29. High MCV/MCH Blood film Normal or low Reticulocyte count Non megaloblastic Normoblastic Bone marrow morpology Megaloblastic Folate and vit B12 Dyserypoietic Folate low Chronic liver disease Alcoholic Myelodys Folate B 12 low B 12
- 31. Normal MCV/MCH Blood film Reticulocyte count High Acute blood loss Hemolysis Normal or low Bone marrow morpology
- 32. Increased RBC production Reticulocytosis Increased RBC break down serum bilirubin LDH Urobilinogen + ve haemosiderin Plasma haptoglobulin Confirm hemolytic anemia
- 34. Autoimmune hemolytic disease Hereditary spherocytosis G6PD deficiency Sickle cell anaemia Non autoimmune-microangeopathic hemolytic anaemia
- 35. 1. Coombs test
- 36. 2. osmotic fragility test
- 37. Blood Picture Hereditary spherocytosis patient Normal blood picture
- 38. Bite or Blister cells
- 40. Aplastic anaemia Normal bone marrow biopsy Normal distribution and cellularity are seen Aplastic patient a – bone marrow aspiration a ̶ bone marrow biopsy Hypocellularity can be seen
- 41. 1 Primary congenital chemicalsbenzene ,toluene Insecticides Infections: Viralhepatitis, HIV , erythrovirus Othertuberculosis 2 Secondary causes Ionizing radiation antibioticschlorampheni col ,gold ,penicillamine , phenytoin ,carbimazole
- 42. Normal Bone marrow morphology Anaemia of Chronic disease Hypoplastic Abnormal Infiltration/Fibrosis
- 45. Chronic myeloid leukemia- blood picture
- 49. Bone Marrow
- 51. Anaemia of chronic disease ESR S.creatinine Further investigations for neoplasm