Presentation on theme: "Course title: Hematology (1) Course code: MLHE-201 Supervisor: Prof. Dr Magda Sultan Outcome : The student will know : -The causes and pathogenesis of."— Presentation transcript:
Course title: Hematology (1) Course code: MLHE-201 Supervisor: Prof. Dr Magda Sultan Outcome : The student will know : -The causes and pathogenesis of aplastic anemia. -The diagnosis of aplastic anemia. -The laboratory tests needed for diagnosis
APLASTIC ANEMIA Aplastic anemia is a severe, life threatening syndrome in which production of erythrocytes, WBCs, and platlets has failed. Aplastic anemia may occur in all age groups and both genders. The disease is characterized by peripheral pancytopenia and accompanied by a hypocellular bone marrow.
Definition of aplastic anaemia. Peripheral blood pancytopenia and a hypocellular marrow in which normal marrow is replaced by fat cells. Abnormal cells are not found.
Normal Haemopoiesis. Red cell life span 120 days. Platelet life span 6 days. Granulocyte life span < 24 hours. Constant marrow activity needed to replace dead cells.
Pathogenesis. Primary defect or damage to haematopoietic stem cell. possible Immunological attack on stem cells.. Defective microenvironment (i.e. marrow stromal defect)
Clinical Features. Anaemia; tiredness & fatigue, palpitations. Low white count; recurrent infections. Low platelets; easy bruising and bleeding.
Investigations. CBC ( Hb < 10 g /dl, TLC < 4000 /cmm, platelets < 100,000 /cmm ) Reticulocyte count ( decreased ) Blood film. B12/folate. Liver function tests Virology Bone marrow aspirate & trephine
APLASTIC ANEMIA – Lab findings » Severe pancytopenia with relative lymphocytosis (lymphocytes live a long time) » Normochromic, normocytic RBCs » Mild to moderate anisocytosis and poikilocytosis » Decreased reticulocyte count » Hypocellular bone marrow with > 70% yellow marrow
Severe Aplastic Anaemia Peripheral Blood oGranulocytes <0.5 x 10 9 /l oPlatelets <20 x 10 9 /l oReticulocytes <1% Marrow trephine Markedly hypocellular <25% normal
HYPOCELLULAR BONE MARROW IN APLASTIC ANEMIA
OTHER HYPOPROLIFERATIVE ANEMIAS Renal disease – due to decreased erythropoietin Endocrine deficiencies – may lead to decreased erythropoietin production. For example: hypothyroidism leads to decreased demand for oxygen from tissues; decreased androgens in males; decreased pituitary function