Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
By
Dr Shaza Abdel wahab
Professor of hematology and
BMT
Ain Shams university
Cairo -Egypt
Objectives :
Approach to diagnosis (work-up ) of anemias
Diagnosis and management of iron deficiency
anemia
Highlighting anemia in special situations :
elderly people, critical care units and pregnancy
and lactation
Screening for hemoglobinopathies
Important notes on Sickle cell anemia
Definition of Anemia :
According to the WHO criteria as HB values
<12g/dl in women and <13g/dl in men.
Diagnosis of Anemia
MCV,MCH,MCHC,peripheral smear and
retics count
Low
NN
retics
1-iron def.anemia
1-Bm infiltration
2-hemoglobinopathies 2- anemia of CRF
3-Anemia of ch.illness 3-endocrinal
4-lead poisoning
4-hemolysis and
5-sideroblastic anemia hemorrahge
high(Macrocytic )
1-megaloblastic
2-non megalobl
-astic
MDS,CLD,alcohol
-ism
in developed countries
GI bleeding is adult
males and post-meno
pausal females
Menstrual bleeding in
adult females
Highlights on treatment :
1-typical replacement doses are 200mg elemental iron daily in
adults ,3-6mg/kg /d for infants and children in divided doses.
2-taken on empty stomach ,however better tolerated with food.
3- Vit C the absorption of inorganic (non hem iron )
4- failure of response either : non compliance or mal-absorption
syndrome.
5- Antacids ,tannis(tea),Ca supplementation ,bran and whole grains
iron absorption if taken concurrently.
6-duration of therapy: HB rises 1-2 wks with rise of reticulocytic
count and should continue 6-9mo(replete B.stores)
7- IMI should not be given (painful and associated with soft T.
sarcoma.)
As result of inflammation
in Epo production
Short RBCs survival
1-faster mean
of HB level
2-avoid side effects
of ESA
1-costy
2-poor outcomes
with risk of
mortality and
morbidity
TRAIL,TRACO,TRI
Causes :
1-Iron deficiency anemia
2-folate and B12 deficiency
3-other micronutrient deficiences
4-infectious diseases in pregnancy
5-Hemoglobinopathies
6-Aplastic anemia and pregnancy