تويت
ANAEMIA
The first step in the diagnosis is to carry out a complete blood count (CBC), blood indices (mean corpuscular volume MCV & mean corpuscular hemoglobin MCH) as well as a reticulocytic count.
NORMOCYTIC NORMOCHROMIC ANAEMIA (normal MCV & MCH):
1) Anaemia of chronic disorders :
• Chronic infections : Culture, ESR, CRP.
• Chronic inflammations : Rheumatoid factor, Autoantibodies (ANA, DNA, etc.).
• Hematologic malignancy : Bone marrow, Immunophenotyping, Cytochemistry.
• Solid tumours : Tumour markers.
2) Some hemolytic anaemias .
3) Hypothyroidism : Free (T3 & T4), TSH.
4) Renal failure : Creatinine clearance .
5) Addison's disease : Cortisol (9 a.m. & 9 p.m.), ACTH.
6) Panhypopituitarism : FSH, LH, PRL, TSH, ACTH, Growth hormone.
MICROCYTIC HYPOCHROMIC ANAEMIA (Decreased MCV & MCH ):
1) Iron deficiancy : Serum Iron , TIBC , Ferritin.
2) Thalassaemia & Sickle cell anaemia : Hemoglobin electrophoresis, PCR.
MACROCYTIC ANAEMIA (Increased MCV):
Vitamin B12 , Folate , Liver functions, Bone marrow iron stain for refractory or Siderblastic anaemia.
HEMOLYTIC ANAEMIA :
• Indirect Bilirubin is increased.
• Haptoglobin is consumed.
• Hemoglobin electrophoresis to detect any hemoglobinopathy such as Thalassaemia or Sickle cell anaemia.
• Quantitative G6PD assay.
• Coomb's test ( indirect & direct for both cold and warm antibodies) to diagnose Immune hemolytic anaemia.
• Acidified Serum Lysis Test for paroxysmal nocturnal haemoglobinuria.
• Red cell Pyruvate Kinase assay.
• Hemoglobin H detection.
The first step in the diagnosis is to carry out a complete blood count (CBC), blood indices (mean corpuscular volume MCV & mean corpuscular hemoglobin MCH) as well as a reticulocytic count.
NORMOCYTIC NORMOCHROMIC ANAEMIA (normal MCV & MCH):
1) Anaemia of chronic disorders :
• Chronic infections : Culture, ESR, CRP.
• Chronic inflammations : Rheumatoid factor, Autoantibodies (ANA, DNA, etc.).
• Hematologic malignancy : Bone marrow, Immunophenotyping, Cytochemistry.
• Solid tumours : Tumour markers.
2) Some hemolytic anaemias .
3) Hypothyroidism : Free (T3 & T4), TSH.
4) Renal failure : Creatinine clearance .
5) Addison's disease : Cortisol (9 a.m. & 9 p.m.), ACTH.
6) Panhypopituitarism : FSH, LH, PRL, TSH, ACTH, Growth hormone.
MICROCYTIC HYPOCHROMIC ANAEMIA (Decreased MCV & MCH ):
1) Iron deficiancy : Serum Iron , TIBC , Ferritin.
2) Thalassaemia & Sickle cell anaemia : Hemoglobin electrophoresis, PCR.
MACROCYTIC ANAEMIA (Increased MCV):
Vitamin B12 , Folate , Liver functions, Bone marrow iron stain for refractory or Siderblastic anaemia.
HEMOLYTIC ANAEMIA :
• Indirect Bilirubin is increased.
• Haptoglobin is consumed.
• Hemoglobin electrophoresis to detect any hemoglobinopathy such as Thalassaemia or Sickle cell anaemia.
• Quantitative G6PD assay.
• Coomb's test ( indirect & direct for both cold and warm antibodies) to diagnose Immune hemolytic anaemia.
• Acidified Serum Lysis Test for paroxysmal nocturnal haemoglobinuria.
• Red cell Pyruvate Kinase assay.
• Hemoglobin H detection.
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