microctic new ONE.pptx on Microcytic Anaemias

Microcytic Anaemias

1. TOPIC: NORMOCYTIC AND MICROCYTIC ANAEMIAS. Understanding Normocytic and Microcytic Anemias By: ISSAH BARIKISU SURAJI NAANA-HAWA AKUFFO ANITA SIDICK B.W. AYISHA 1

2. AGENDA 1. BRIEF OVERVIEW 2. COMMON SYMPTOMS OF ANEMIAS 3. CLASSIFICATION OF ANEMIAS 4. IRON DEFICIENCY ANEMIA 5. THALASSAEMIA 6. ANAEMIA OF CHRONIC DISEASE 7. LEAD POISONING 2

3. BRIEF OVERVIEW Anemia is a condition characterized by a decrease in the number of red blood cells or a decrease in their ability to carry oxygen. Anaemia is defined as a haemoglobin level two standard deviations below the normal for a particular age and sex. 3

4. COMMON SYMPTOMS OF ANEMIAS INCLUDE: Fatigue Palpitations Cold hands and feet Shortness of breath. Dizziness Pallor 4

5. CLASSIFICATION OF ANEMIAS The classification of anemias is based on mean corpuscular volume (MCV) and iron studies. Anemias are classified into three types based on the MCV. They are: Normocytic anemia Microcytic anemia Macrocytic anemia The main focus for this presentation will be on normocytic and microcytic anemias. 5

6. NORMOCYTIC ANEMIAS Normocytic anemia is a condition characterized by normal red blood cell size, with anemia present. This subset of anemias is identified by a normal MCV of between 80-100. As the size of the RBCs isn’t altered, the decreased hemoglobin could be due to another cause, either hemolysis (intravascular or extravascular) Chronic diseases (e.g., chronic kidney disease),bone marrow disorders, inflammation or underproduction of normal-sized RBCs. 6

7. NORMOCYTIC ANEMIAS (CONT’D) The reticulocyte count enables differentiation between the two causes. A high reticulocyte count would indicate that the bone marrow was functioning normally and therefore the anemia is not likely to be due to underproduction. Unlike microcytic anemias, normocytic anemias are usually normochromic. Clinical features: Fatigue, weakness, shortness of breath. Diagnosis: Blood tests, including complete blood count (CBC) with reticulocyte count, and peripheral blood smear. 7

8. MICROCYTIC ANEMIAS Definition: Microcytic anemia is a condition characterized by RBCs size being smaller than that of normal RBCs. These conditions can be passed down from parents to their children through genetic mutations. Causes: Iron deficiency, thalassemia, anemia of chronic diseases, lead poisoning Characteristics: Hypochromic microcytic RBCs Diagnosis: MCV measurement, iron studies, lead levels 8

9. IRON DEFICIENCY ANEMIA AETIOLOGY It is the most common cause of microcytic anemia. In iron-deficiency anaemia , there is a lack of iron, which is a vital component of haemoglobin . This condition often presents with mild symptoms. Symptoms Include: Fatigue, palpitations, pale skin, brittle nails, etc. and can sometimes lead to strange cravings for ice, dirt, or starch. 9

10. Contd. Iron deficiency is most often caused by chronic blood loss but can also be due to dietary deficiency, malabsorption or increased requirements during childhood or pregnancy. Any patient over 40 with iron deficiency anaemia requires an upper and lower gastrointestinal endoscopy for further investigations. 10

11. IRON DEFICIENCY ANEMIA Investigation findings Investigation findings in iron deficiency anaemia include: Low MCV <80 Serum iron: low Transferrin saturation: low Ferritin: low Total iron-binding capacity: high (there is an inverse relationship between ferritin and TIBC) Diagnosis: Low serum ferritin, low iron, high total iron-binding capacity (TIBC). Treatment: Iron supplementation, dietary changes. 11

12. Aetiology Thalassaemias occur due to inherited mutations affecting the globin gene. They can be further classified into the specific gene that is affected (alpha or beta), as well as the severity of the condition (major, minor or trait). People with the thalassaemia trait may be asymptomatic or have very mild symptoms, while thalassaemia major can be severe enough to require regular transfusions. THALASSAEMIA 12

13. The most frequent occurrences of thalassaemias are in the Mediterranean, Africa, Western and Southeast Asia, as well as India and Burma. This condition seems to be protective against Plasmodium falciparum​ malaria, which is why the population distribution is so similar for the two conditions. Thalassaemias result in classic clinical features such as chipmunk facies. Management ma include blood transfusions and chelation therapy to remove excess iron. THALASSAEMIA 13

14. ANAEMIA OF CHRONIC DISEASE Aetiology In anaemia of chronic disease, underlying chronic diseases such as malignancy, chronic infections such as rheumatoid arthritis and cancer, or autoimmune conditions, cause the liver to produce acute phase reactants such as hepcidin. 14

15. Contd , Hepcidin blocks the iron in ferritin to reduce availability in the serum. Anaemia of chronic disease starts out as normocytic anaemia but it can progress to microcytic anaemia . 15

16. ANAEMIA OF CHRONIC DISEASE Investigation findings Investigation findings in anaemia of chronic disease include: Normal MCV (80-100) or low MCV (<80) Serum iron: low Transferrin saturation: low Ferritin: high Total Iron Binding Capacity: low 16

17. LEAD POISONING Lead exposure leading to microcytic anemia. Sources : Paint, contaminated water, certain occupations. Symptoms : Abdominal pain, cognitive issues etc. Diagnosis : Blood lead levels. Prevention : Identify and eliminate lead sources. 17

18. LEAD POISONING Lead poisoning causes microctic anaemia as a result of interfering with heme biosynthesis and diminishing red cell survival. It sometimes comes with associated reticulocytosis . 18

19. Contd , Key diagnostic tests: CBC, peripheral blood smear, iron studies, lead levels. Importance of patient history and physical examination in guiding diagnosis. Treatment Iron supplementation for iron deficiency, blood transfusions for severe anemias. Address underlying cause, supportive care. 19

20. Peripheral Blood Smear Of A Thalassemia Patient 20

21. Sample of a CBC or FBC test results of a Thalassemia patient 21

22. Microctic anaemia smear 22

23. CBC Report of Iron Deficiency anaemia patient 23

24. IRON DEFICIENC ANAEMIA Notice the RBC size is smaller than the nucleus of small lymphocyte. 24

25. Normal Peripheral Blood smear 25

26. REFERENCES Iron Deficiency Anaemia slides by Dr. Lynda Addo – ATU, Accra. Thallassemia slides by Dr. Lynda Addo – ATU, Accra. Aplastic anaemia slides by Dr. Lynda Addo – ATU, Accra. Geek Medics Guide to Iron Defeciency Anaemia . Thallassemia Slides by Charles Nkansah- UDS,Tamale . 26

27. THANK YOU 27