Course title: Hematology (1) Course code: MLHE-201 Supervisor : Prof. Dr Magda Sultan
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Transcript of Course title: Hematology (1) Course code: MLHE-201 Supervisor : Prof. Dr Magda Sultan
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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
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Aplastic Anaemia
.
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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.
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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.
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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.
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Pathogenesis.• Primary defect or damage to haematopoietic
stem cell.• possible Immunological attack on stem cells. .• Defective microenvironment (i.e. marrow
stromal defect)
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Haematopoietic stem cell.
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Pathophysiology of aplastic anemia
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Aetiology.(Causes )• INHERITED(20%)o Fanconi Anaemiao Dyskeratosis congenitao Shwachman-Diamond
syndromeo Diamond-Blackfan anaemia.
• ACQUIRED(80%)o Idiopathico Drug inducedo Viral (hepatitis, EBV)o Ionising radiationo Toxins (pesticides,
benzene, arsenic)o Pregnancy o leukaemic
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Clinical Features.• Anaemia; tiredness & fatigue, palpitations .
• Low white count; recurrent infections .
• Low platelets; easy bruising and bleeding.
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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
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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
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Severe Aplastic Anaemia
• Peripheral Blood o Granulocytes <0.5 x 109/lo Platelets <20 x 109/lo Reticulocytes <1%• Marrow trephine• Markedly hypocellular <25% normal
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Marrow trephine
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HYPOCELLULAR BONE MARROW IN APLASTIC ANEMIA
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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
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Assignement: Topic Student Names
Acquired aplastic anaemia عشري محمد حماده
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Training questions :
What are the laboratory findings in aplastic anaemia ?
How to diagnose Aplastic anaemia ?
• Reference book :• Essential Hematology .• Dacie .