Hemoglobin synthesis

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 Pro-Erythroblast

Basophilic
Erythroblast

Polychromatophilic
Erythroblast

Orthochromic Erythroblast

Reticulocyte

Red Blood Cell

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Absorption of iron

Apotransferri
n
transferrin
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Total body content 30 %
4-5 gm
Storage-
Feritin, Hemosiderin

4%
O2 storage protein
Myoglobin

65 %
For Hb synthesis 1%

Dr.Ashok Solanki Heme Enzymes 6

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Factors required for erythropoisis

 Erythropoietin
 Growth factors
 Vitamins
 Thyroid and other anabolic hormones
 First class proteins

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Varieties of haemoglobin
ADULT Hb-
1. HbA-
 It forms 97% of adult Hb.
 It consists of 2 α and 2 β polypeptide chains.
 It begins to form in 8th week of foetal life and reaches
the adult levels within a few months after birth.
2. HbA2-
 it accounts for 1.5-3% of total adult Hb.
 it has 2 α and 2 Δ polypeptide chains.
 Its functional behavior is probably similar to HbA.

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Anaemia
 Definition –

Decrease O2 carrying capacity of blood

due to
1) RBC count < 4 millions / cmm of blood
or
2) Hb is < 12 gm %
or
3) Both (1) and (2).

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Grading of anaemia

1. Mild - Hb is 8 – 12 gm %
2. Moderate – Hb is 5 – 8 gm %
3. Severe – Hb is < 5 gm %

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Blood indices

1) MCV = Mean corpuscular(RBC) volume.

 Normal value = 78 – 94 µm3
 Depending upon the RBCs are known-
 If MCV is normal ---------- Normocytic.
 If MCV is < 78 µm3 ------- Microcytic.
- Iron defi. Anemia.
- Globin defi. Anemia.
 If MCV is > 94 µm3 -------- Macrocytic.
-Vitamin B12 & folic acid deficiency.

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3) MCH = Mean corpuscular Hb.
It indicates the amount of Hb per red cell
 Normal value – 28 -32 pg

 Higher MCH- found in Macrocytic anaemia

 Lower MCH- found in Hypochromic anaemia

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Classification
1) Morphological classification (Wintrobe’s)
a) Normocytic normochromic anaemia
- Acute haemorrhagic anaemia
- All hemolytic anaemia
- Aplastic anaemia
b) Macrocytic normochromic anaemia
- All megaloblastic anaemia
c) Microcytic hypochromic anaemia
- Iron deficiency anaemia
- Thalassemia

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