ANEMIA DEFINITION & CLASSIFICATION

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Maj Gen (R) Masood Anwar
Professor of Haematology
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Functions of blood
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Transport of nutrients
Transport of gases
Haemostasis
Defence
Composition of blood
◦ Cells (RBC, WBC, Platelets)
◦ Plasma (Colloids, Crystalloids, Water)
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PYSIOLOGICAL DEFINITION
◦ Decrease in oxygen carrying capacity of blood.
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ANALYTICAL (PATHOLOGICAL) DEFINITION
◦ Reduction in total circulating red cell mass
◦ Reduction in Haemoglobin concentration and/or
Haematocrit
These are blood cells produced in the bone
marrow from a pleuripotent haemopoietic
stem cell by processes of division,
differentiation and maturation and released in
the circulation to function mainly to transport
oxygen from lungs to other tissues of the
body.
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Haemoglobin (Hb)
Haematocrit (Hct)
[Packed Cell Volume (PCV)]
Total Red Blood Cell Count (TRBC)
Mean Cell Volume (MCV)
Mean Cell Haemoglobin (MCH)
Mean Cell Haemoglobin Concentration
(MCHC)
Red Cell Distribution Width (RDW)
PARAMETER
ADULT MALE
ADULT FEMALE
Hb
13-17 g/dl
12-16 g/dl
TRBC
4.5-6.5 X 1012/l
4.2-6.0 X 1012/l
Hct/PCV
40-54%/0.40-0.54 l/l
36-49%/0.36-0.49 l/l
MCV
76-96 fl
MCH
27-32 pg
MCHC
31.5-34.5 g/dl
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MORPHOLOGICAL CLASSIFICATION
Based on appearance of RBC under the microscope
OR red blood cell indices
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PATHOLOGICAL CLASSIFICATION
Based on abnormality of anatomical, biochemical
or physiological abnormality
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ETIOLOGICAL CLASSIFICATION
Based on specific causative process/agent
Normocytic normochromic anaemia
Hypochromic Microcytic Anaemia
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Iron deficiency anaemia
Thalassaemia minor
Sideroblastic anaemia
Anaemia of chronic disorders
Macrocytic anaemia
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Megaloblastic anaemia
Aplastic anaemia
Myxoedema
Chronic Obstructive Pulmonary Disease
Liver Disease
Myelodysplastic syndromes
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Blood loss
◦ Acute
◦ Chronic
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Decreased production
◦ Disturbance of proliferation and differentiation
 Of stem cells
 Of erythroblasts
◦ Defective Hb synthesis
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Increased destruction
◦ Intracarpuscular (Intrinsic) defects
◦ Extracarpuscular (Extrinsic) defects
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Hereditary
◦ Blood loss – Hereditary Intestinal telengiectasia
◦ Decreased production – Pure Red Cell aplasia
◦ Increased destruction – Membrane, Enzyme and Hb
defects
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Congenital
◦ Defective production – Congenital dyserythropoietic
anaemia,Congenital sideroblastic anaemia
◦ Increased destruction – Cardiac defects, vascular
defects
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Acquired
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Blood loss
◦ Acute
◦ Chronic
 Ulcerative lesions of GIT
 Female reproductive system
 Parasites – Ankylostoma duodenale, Schistosoma
haematobium
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Increased destruction of RBC
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Membrane defect (PNH)
Mechanical trauma (Microangiopathies)
Antibody mediated (Immune haemolytic anaemia)
Parasites (malaria, Aroya fever)
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Decreased production
◦ Deficiency anaemias
 Iron deficiency
 Vitamin B12 and Folate deficiency
◦ Bone marrow disease/infiltration
◦ Miscellaneous
 Pyridoxin responsive anaemia
 Sideroblastic anaemia
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