SEC S20W4 || Hematology [Etiopathogenic Anemias - Module 4]

Etiopathogenic anemia

Firstly I would like to save you know as a doctor I have been through the hematology so many time but I think for the very first time I heard and this term so far me it is very improvement team to know something which is very new for me and in most of our book I never read about etiopathogenic anemia.

So this is a different kind of anaemia which means that there is decreased red blood cells in our body and which can lead to decreasing oxygen carrying capacity to all over body tissues and organs and cells.

Now what is the cause why there is decrease red blood cells production in our body we need to learn about that.

Morphological classification which terms as etiopathogenic anemia so basically when there is baby Red blood cells or reticulocyte increase in circulation terms as etiopathogenic anemia.Lets me give you example of dengue now I have seen in Pakistan there is wave of dengue so patients blood active hemolysis going on in order to compensate there is increased number of reticulocyte in the patient blood.Thanks God we have IPR which helps to classify anemia into generative and Agenerative anemia.

So I have divided the pathogenesis into two factors their maybe intrinsic factor inside our body and the other one may be the extrinsic factor from outside our body

Intrinsic factor main three leading cause is the iron deficiency vitamin B12 and the folic acid deficiency these are the three main common deficiency in our part of the world and then we came out with thalassemia, sickle cell anemia and some bone marrow disorders for example myelodysplastic syndrome.

If I go in detail of extrinsic factor so most common things which we are suffering in Pakistan the kidney diseases CKD patient tuberculosis is very common in our part of world hepatitis h i v and some of antibiotics.

So all of these factors are leading to impairment in the red blood cell product and so there is active hemolysis of the red blood cell and as a result there is anemia in the body.

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Maturation of UFC-E diagram

So now I will explain each step by step through a proerythroblasts which have mainly nucleus in high content as compared to cytoplasm with chromatin and one nucleoli.cytoplasm blue in color.

Early proerythroblasts have no nucleolus but have high cytoplasm with blue color and chromatin also condensed.

Late or polychromatophilic erythroblast

Mature chromatin with no nucleolus and cytoplasm changes it's Color to blue because at this stage hemoglobin is started forming.

Then this nucleus changes the color to pink so that well hemoglobin is formed.

Reticulocyte

Nucleus has been extruded remnant of rRNA and ER.large normal red cells stain with cresylic Blue.

Mature red blood cells has no nucleus and pale in color.

Are generative anemia vs regenerative anemia

There is very important and I think the main lead and which is called reticulocyte prediction index and this is a very important indicator for the classification between Generative and Agenerative anemia.

When we stained the blood cells with cresyl blue we can see the immature red blood cells in peripheral smear. When the reticulocytes are present in larger numbers, they are rapidly entering into circulation.This is a regenerative type of anemia in which more than 3 percent immature red blood cells present in the circulation.

If IPR is just 1 percent or 1-2 percent that is called the Regenerative type of anemia.

In this way IPR help to distinguish between these two types very efficiently.

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Give suggestions in the case of bleeding

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When there is active bleeding in the body first of all is patient is in hospital so we have to stop the bleeding to prevent hypovolumeic shock.

We can stop bleeding by applying pressure by applying the eyes by placing gauze pieces.

Then we have to rule out what is the cause of bleeding and need to manage according to the cause.

When there is bleeding going on in our body our kidney is really Superman in that case the kidney produces one hormone which is called erythropoietin which in turn stimulates the bone marrow and the precursors of bone marrow leading to speed up the production of red blood cells so as a result red blood cells increase in the body in relation to bleeding.