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Anemia and Vitamin Deficiencies: Causes, Symptoms, and Treatments, Lab Reports of Pathophysiology

An in-depth analysis of various types of anemia, including iron deficiency anemia and vitamin b12 deficiency anemia. It covers the causes, symptoms, and treatments of these conditions, as well as the role of compensatory mechanisms and underlying causes. The document also discusses normal erythropoiesis and other related blood disorders.

Typology: Lab Reports

Pre 2010

Uploaded on 08/08/2009

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Blood and Lymphatic
Disorders
Bio 375
Pathophysiology
Blood Dyscrasias
The anemias:
Cause a reduction in oxygen transport in
the blood due to:
Decrease in hemoglobin production
Decrease in erythrocytes
Combination of these two
Oxygen deficit results:
Less energy is produced in cells
Cell metabolism is decreased
Cell reproduction is decreased
Results of Anemia
Compensatory mechanisms include
tachycardia and peripheral
vasoconstriction
This leads to fatigue, pallor, dyspnea
and tachycardia
Decreased regeneration of epithelial
cells causes the digestive tract to
become inflamed and ulcerated;
cracked lips; dysphagia; hair and skin
may show degenerative changes
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Blood and Lymphatic

Disorders

Bio 375

Pathophysiology

Blood Dyscrasias

„ The anemias: „ Cause a reduction in oxygen transport in the blood due to: „ Decrease in hemoglobin production „ Decrease in erythrocytes „ Combination of these two „ Oxygen deficit results: „ Less energy is produced in cells „ Cell metabolism is decreased „ Cell reproduction is decreased

Results of Anemia

„ Compensatory mechanisms include tachycardia and peripheral vasoconstriction „ This leads to fatigue, pallor, dyspnea and tachycardia „ Decreased regeneration of epithelial cells causes the digestive tract to become inflamed and ulcerated; cracked lips; dysphagia; hair and skin may show degenerative changes

„ Severe anemia may lead to angina during stressful situations if oxygen supply to the heart is sufficiently reduced

„ Chronic severe anemia may cause congestive heart failure

„ Anemia may occur when: „ There is a deficiency of a nutrient „ When bone marrow function is impaired „ When blood loss is excessive „ When there is excessive destruction of RBC’s

Iron Deficiency Anemia

„ Very common „ Ranges from mild to severe „ Occurs in all age groups „ Lack of iron impedes synthesis of Hb „ Produces microcytic, hypochromic RBC’s „ Decrease in stored iron with: „ Decreased serum ferritin „ Decreased hemosiderin „ Decreased iron containing histiocytes in bone marrow

Etiology of Iron Def Anemia

„ Iron deficit can occur for several reasons: „ Inadequate iron containing vegetables or meat in diet „ Chronic blood loss from ulcers, hemorrhoids, cancer or excessive menstrual flow „ Malabsorption syndromes, e.g. achlorhydria „ Severe liver disease „ In some infections and cancer, iron is absorbed but not well utilized; leads to low hemoglobin counts but high iron storage levels

Pernicious Anemia (B 12 Def)

„ Characterized by very large, immature, nucleated erythrocytes (megaloblastic anemia)

„ Usually results from deficits of either folic acid (vitamin B 9 ) or vitamin B (^12) „ Folic acid deficits usually diet related „ B 12 deficit may have multiple causes

Vitamin B 12 Deficiency

„ Often caused by the malabsorption of B 12 due to a lack of intrinsic factor (IF) from the gastric glands of the stomach

„ Lack of IF usually due to:

„ Formation of autoantibodies against IF or the parietal cells that produce it; results in atrophy of the gastric mucosa „ Any condition that reduces the gastric mucosa

„ The gastric mucosa atrophy not only causes IF deficiency but also achlorhydria which interferes with: „ Early protein digestion „ Absorption of iron „ Iron deficiency may coexist with pernicious anemia

„ Vitamin B 12 must bind to IF to enable absorption of the vitamin in the lower ileum.

„ Deficiency of vitamin B leads to impaired maturation of erythrocytes (it interferes with DNA synthesis) „ The RBC’s are very large and many have nuclei „ They are destroyed prematurely leading to low hemoglobin count or anemia „ Often granulocytes are also affected with hypersegmented nuclei

Additional Problems

„ Thrombocyte (platelet) levels may be low „ Lack of B 12 is also a direct cause of demyelination of nerve fibers of peripheral nerves and eventually the spinal cord; first sensory nerves are affected and later motor nerves are involved „ Demyelination interferes with nerve conduction

Etiology and Treatment

„ Dietary deficiency not typically a cause „ Most common cause is malabsorption: „ Autoimmune reaction „ Chronic gastritis „ Inflammatory conditions like regional ileitis „ Oral supplements for pregnant women and vegetarians „ B 12 injections for people with pernicious anemia

Signs and Symptoms

„ Anemia (pallor, weakness and dyspnea

„ Leukopenia with recurrent or multiple infections

„ Thrombocytopenia with small pinpoint hemorrhages and a tendancy to bleed excessively especially in the mouth

Etiology

„ About half the cases are middle aged and cause is unknown or ideopathic

„ In others, damage may be caused by myelotoxins, such as: „ Radiation „ Industrial chemicals (e.g. benzene) „ Drugs (e.g. chloramphenicol, gold salts, phenylbutazone, phenytoin, antineoplastic drugs)

„ Also viruses, particularly hepatitis C may cause aplastic anemia

„ If the risk is from cancer treatment, a patients stems cells may be harvested prior to drug treatment and then transfused later when needed

Other Blood Disorders Include

„ Hemolytic anemias „ Sickle cell anemia „ Thalassemia

Other Blood Disorders Include

„ Polycythemia vera „ Blood clotting disorders „ Hemophilia A „ Disseminated Intravascular Coagulation

Lymphatic Disorders

„ These are malignant neoplasms involving lymphocyte proliferation in the lymph nodes

„ Two types are distinguished on the basis of lymph node biopsy: „ Hodgkin’s Lymphoma „ Non- Hodgkin’s Lymphoma

„ No specific etiology is known

Hodgkin’s Lymphoma

„ Primarily occurs in adults 20-40 years old „ Initially involves a single lymph node but progresses to adjacent lymph nodes and finally to other organs via the lymphatic system

„ T lymphocytes appear to be defective „ Lymphocyte count is depressed „ Reed-Sternberg cell, found in lymph nodes, is used as marker in diagnosis

„ Typical spread of Hodgkin’s lymphoma

Reed-Sternberg Cell

(large cell with irregular nucleus)

„ Staging is based on number of nodes and organs involved and whether they are located on one or both sides of the diaphragm „ Treatment involves: „ Radiation „ Chemotherapy „ Surgery „ Prognosis in early stages is excellent