CLASIFICACION DE ANEMIAS PDF
The pathophysiology of anemia and the basis of its clinical investigation. Pruebas que evalúan el estado del hierro: Hierro del compartimiento funcional: Ferremia: Capacidad total de saturación de hierro (CTSH). Transcript of Clasificacion de anemias. Disminución de la capacidad transportadora de oxigeno de la sangre. Adaptaciones fisiológicas.
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Acute hemolysis is characterized by sudden episodes with very obvious clinical signs fever, chills, back pain, dark urine and typical laboratory data hemoglobinuria and reduced plasma haptoglobin [ 16 ]. In the absence of intake of any of the drugs mentioned above or alcohol, the most frequent cause of microcytic anemia is nutritional deficiency[ 50 ]. Nutritional Anemias and Anemia of Chronic Disease 4. Table 6 Differential diagnosis of anemia from a gastrointestinal point of view.
Hemoglobinopathies and Thalassemias I. The starting point in the diagnostic process for macrocytic anemia will be to rule out therapy with drugs that interfere with nucleic acid metabolism, such as.
The next step is the calculation of reticulocyte production index RPI: The normoregenerative anemias are in contrast to those characterized by inadequate marrow response to the degree of anemia.
Anemia is one of the most frequent causes of medical visits because of the high incidence in children, young women and elderly people, especially if malnutrition is present. The expected reticulocyte count is much higher than normal to compensate for the anemia. Activation of cytokines and the reticuloendothelial system induces changes in iron homeostasis, erythroid precursor proliferation, erythropoietin secretion, and erythrocyte life span[ 43 ].
Serum haptoglobin concentration When an rbc is destroyed, the liberated hemoglobin binds mole-for-mole with a serum protein, haptoglobin. Normal serum levels of homocysteine are highly unlikely in folate deficiency[ 21 ].
Anemia: Pathophysiology, Classification, Clinical Investigation
Pitiriasis Rosada de Gibert. The clasiifcacion of the number of myeloid to erythroid precursors the M: The former is extremely rare. The study of the small bowel is more controversial, but it is convenient to keep in mind that celiac disease is a cause of IDA[ 35 ]. Gastrointestinal investigations for anaemia in the elderly: Therefore, gastrointestinal exploration is controversial.
Classification of anemia for gastroenterologists
Other parameters of iron metabolism serum iron, total transport capacity of iron, and transferrin are unable to distinguish with certainty IDA from ACD[ 23 ]. Vitamin B12 absorption takes place chiefly in the ileum. Its prevalence is 1. En la tabla I se resumen las causas de deficiencia de vitamina B Serum antibodies against intrinsic factor and parietal cells are not sensitive or specific enough to confirm the diagnosis.
Table 1 Etiopathogenic classification of anemia. Biochemical classification Finally, one should attempt to determine the etiology of the anemia as specifically as possible. All of the substances whose names are boxed in the diagram are those whose laboratory measurement is feasible and helpful in documenting hemolysis.
It will always be necessary to rule out hemolysis, by performing easily accessible laboratory tests [lactate dehydrogenase LDHindirect bilirubin, haptoglobin and reticulocytes]. The exploration that leads directly to diagnosis is gastroscopy, with mucosal biopsy and study of antiparietal cell antibodies.
Hemolytic anemia follows next in order of frequency. Nevertheless, the clazificacion estimate of the actual erythropoietic activity[ 15 ], and easiest to calculate, is to divide by two the number of reticulocytes per mm 3. Hereditary anemia is extremely rare, except for thalassemia and sickle cell disease in certain geographical areas.
This is caused by alteration of bone marrow progenitor cells, which can be located at different stages of differentiation and maturation. Bone marrow biopsy This can be used to directly observe any accelerated production of rbc’s.
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Kepczyk T, Kadakia SC. Among malabsorption causes of B12 vitamin deficiency, the most frequent is pernicious anemia. On the other hand, macrocytosis can be physiological in some circumstances infants, pregnancy, some families. Eur J Clin Invest. This rule does not apply to infants, children and pregnant women, who have their own tables of lower limits of hemoglobin concentration.
Digestive diseases potentially causing anemia have been studied in preference, but other causes of anemia have been included in the text and tables.
Clasificacion de anemias by Carolina Isabel Guifarro Salgado on Prezi
What remains in the plasma spontaneously degrades into metheme and globin. Erythrocytes and the digestive system are linked closely from the very beginning of life.
Keep in mind that if anemia develops through rapid enough bleeding, the hematocrit and hemoglobin will be normal since in hemorrhage the rbc’s and plasma are lost in proportion. In this situation, it is fundamental that a careful clinical evaluation is carried out to rule out other causes of normocytic anemia: Therefore, we should keep in mind ACD as the most likely diagnosis in elderly and inpatients, and as the second most likely diagnosis cllasificacion outpatients under 65 years of age[ 68 ].
Therefore, when the bone marrow shows a normal regenerative capacity, there should be an inverse relationship between the decrease in hemoglobin and the increased number of reticulocytes regenerative anemia. Over time, chronic hemorrhagic anemia becomes hypo-regenerative clasficacion microcytic because of depletion of iron stores.
Through a series of biochemical steps too boring to go into even here, the heme is changed into bilirubin. In d B12 and folic acid deficiency, as well as in other diseases, macrocytosis blood is accompanied by megaloblastosis bone marrow.
In anemia of renal failure, morphological alterations in the blood are scarce and serum erythropoietin may be normal, but inappropriately low for the degree of anemia. Hypo-regenerative anemia This is caused by alteration of bone marrow progenitor cells, which can be located at different stages of differentiation and maturation.
In pernicious anemia, pepsinogen I levels are low, gastric pH is high and gastric acid secretion does not respond to stimulation with histamine or pentagastrin. Despite ferritin being an acute phase reactant, the diagnosis of IDA is unlikely with normal or elevated ferritin levels.
ACD is the most prevalent form of anemia after IDA in the general population[ 4068 ], but is even more common in hospitalized patients, regardless of sex and age[ 42676970 ].