Anemia-Hematologic Disease-Pathophysiology

Anemia is a prevalent hematologic condition characterized by a deficiency in the number or quality of red blood cells (RBCs) or hemoglobin, leading to inadequate oxygen delivery to tissues. Common symptoms include fatigue, weakness, pallor, and shortness of breath. There are several types of anemia, each with distinct causes: iron deficiency anemia, often resulting from poor dietary intake or chronic blood loss; vitamin deficiency anemia, caused by insufficient levels of vitamins like B12 or folate; anemia of chronic disease, associated with chronic infections or inflammatory conditions; aplastic anemia, where the bone marrow fails to produce enough blood cells; and hemolytic anemia, due to the accelerated destruction of RBCs. Diagnosis typically involves blood tests to measure hemoglobin levels and other blood indices, alongside assessments of iron and vitamin levels. Treatment depends on the underlying cause and may include dietary changes, supplements, medications, or more advanced interventions such as blood transfusions or bone marrow transplantation. Early diagnosis and effective management are crucial for improving the quality of life and overall health of individuals with anemia.

1. HEMATOLOGICAL DISEASE BY, P.DAKSHINESH

2. HEMATOLOGIC DISEASE Disorder which primarily affect the blood & blood-forming organs. Hematologic disease include genetic disorders, anemia, HIV.

3. ANEMIA A Condition in which the blood does not have enough healthy red blood cells . Anemia results from lack of RBC or dysfunctional RBC in body. This leads to reduced oxygen flow to body’s organs.

4. ANEMIA Anemia is defined as reduced haemoglobin concentration in blood below the lower limit of normal range for the age and sex of the individual. Normal range of haemoglobin in adult, Male= 13g/dl Female= 11.5g/dl New born child has 15g/dl

5. CLASSIFICATION OF ANAEMIA IRON DEFICIENCY ANAEMIA MEGALOBLASTIC ANAEMIA SICKLE CELL ANAEMIA THALASEMIA HEREDITARY AQUIRED ANAEMIA HEMOPHILIA

6. IRON DEFICIENCY ANAEMIA The commonest nutritional deficiency disorder present throughout the world is iron deficiency but its prevalence is higher in the developing countries. The amount of iron obtained from the diet should replace the losses from the skin, bowel and genitourinary tract. These losses together are about 1 mg daily in an adult male or in a non-menstruating female, while in a menstruating woman there is an additional iron loss of 0.5-1 mg daily.

7. PATHOGENESIS OF IRON DEFICIENCY ANAEMIA Iron deficiency anaemia develops when the supply of iron is inadequate for the requirement of haemoglobin synthesis. Initially, negative iron balance is covered by mobilisation from the tissue stores so as to maintain haemoglobin synthesis. It is only after the tissue stores of iron are exhausted that the supply of iron to the marrow becomes insufficient for haemoglobin formation and thus a state of iron deficiency anaemia develops.

8. The development of iron deficiency depends upon one or more of the following factors: 1. Increased blood loss 2. Increased requirements 3. Inadequate dietary intake 4. Decreased intestinal absorption.

9. ETIOLOGY OF IRON DEFICIENCY ANAEMIA I. INCREASED BLOOD LOSS 1. Uterine e.g. excessive menstruation in reproductive years, repeated miscarriages, at onset of menarche, post-menopausal uterine bleeding. 2. Gastrointestinal e.g. peptic ulcer, haemorrhoids, hookworm infestation, cancer of stomach. 3. Renal tract e.g. haematuria, haemoglobinuria. 4. Nose e.g. repeated epistaxis. 5. Lungs e.g. haemoptysis.

10. II. INCREASED REQUIREMENTS 1. Spurts of growth in infancy, childhood and adolescence. 2. Prematurity. 3. Pregnancy and lactation. III. INADEQUATE DIETARY INTAKE 1. Poor economic status. 2. Anorexia e.g. in pregnancy. 3. Elderly individuals due to poor dentition, apathy and financial constraints.

11. IV. DECREASED ABSORPTION 1. Partial or total gastrectomy 2. Achlorhydria 3. Intestinal malabsorption such as in coeliac disease.

12. RISK FACTORS / COMLICATIONS Infants and children growth Vegetarians Heart problems Problem during pregnancy Frequent blood donor

13. SIGNS AND SYMPTOMS Extreme fatigue Weakness Pale skin Chest pain, fast heartbeat or shortness of breath Headache, dizziness or light headedness Cold hands and feet Inflammation or soreness of your tongue Brittle nails Poor appetite

14. DIAGNOSIS Red blood cell size and colour. Hematocrit.  This is the percentage of your blood volume made up by red blood cells.  Hemoglobin.  Lower than normal hemoglobin levels indicate anemia.

15. PHARMACOLOGICAL TREATMENT

16. MEGALOBLASTIC ANEMIA Megaloblastic anemia is an anemia that results from inhibition of DNA synthesis during RBC production. When DNA synthesis is impaired, the cell cycle cannot progress from the G2 growth stage to the mitosis (M) stage. This leads to continuing cell growth without division, which presents as macrocytosis. 

17. PATHOGENESIS OF MEGALOBLASTIC ANEMIA The anemia which is characterized by the formation of morphologically abnormal nucleated red cell precursor called megaloblats in the bone marrow due to megaloblastic erythropoisis. The changes occurs due to deficiency of vitamin B12 or folic acid.

18. ETIOLOGY OF MEGALOBLASTIC ANEMIA The two most common causes of megaloblastic anemia are deficiencies of vitamin B-12 or folate. These two nutrients are necessary for producing healthy red blood cells. When you don’t get enough of them, it affects the makeup of your red blood cells. This leads to cells that don’t divide and reproduce.

19. RISK FACTORS / COMPLICATIONS Lack of intensic factor Auto immune disorder Nervous system disorders.  While vitamin B-12 is important for the production of red blood cells, it's also important for a healthy nervous system

20. SIGNS AND SYMPTOMS Fatigue Shortness of breath Dizziness Pale or yellowish skin Weight loss Numbness or tingling in your hands and feet Muscle weakness Personality changes Mental confusion or forgetfulness

21. DIAGNOSIS The number and appearance of red blood cells.   The amount of folate, vitamin B-12 and vitamin C in your blood.  

22. SICKLE CELL ANEMIA Sickle cell anemia is an inherited blood disorder characterized by sickle-shaped red blood cells — a condition in which there aren't enough healthy red blood cells to carry adequate oxygen throughout your body. It is also called haemoglobin SS disease or sickle cell disease. It is common in people of African origin.

23. ETIOLOGY OF SICKEL CELL ANIMEA Destruction of red bone marrow caused by toxins, gamma radiation, and certain medications that inhibit enzymes needed for hemopoiesis. Sickle cell anemia is caused by a mutation in the gene that tells your body to make the red, iron-rich compound that gives blood its red color (hemoglobin). 

24. RISK FACTORS / COMPLICATIONS Stroke Acute chest syndrome Pulmonary hypertension Organ damage Blindness Leg ulcers Gallstones Priapism

25. SIGNS AND SYMPTOMS Fatigue Pain in chest and bones Painful swelling of hands and feet Frequent infections Infant and children delayed growth Vision problems Pale skin

26. DIGNOSIS A blood test can check for hemoglobin S — the defective form of hemoglobin that underlies sickle cell anemia.