1. Anemia Overview Ruozhi Xiao The Third Hospital of Sun Yat-sen University [email_address]

5. ERYTHROPOIESIS In developing from the stem cell, the RBC has to undergo the most changes, which can be categorized into several morphological/stainable stages Proerythroblast RBC * -blast is the common suffix for an immature form of a cell Early erythroblast Intermediate erythroblast Late erythroblast Reticulocyte … … … … Stem cell

6. Hematocrits Normal, Hemorrhage, IDA, Leukemia, Hemolysis, B12, P Vera Plasma White cells Red cells

11. morphological classification Type MCV fl MCH pg MCHC % Macrocytic anemia ＞ 100 ＞ 32 32-35 Normocytic anemia 80-100 27-32 32-35 Microcytic anemia ＜ 80 ＜ 27 ＜ 32

12. Normal Red Blood Cells - Peripheral Blood Smear

13. Normal Red Blood Cells

15. Microcytic anemia

17. b-Thalassemia

19. Macrocytic anemia

25. Aplastic Anemia Blood Bone Marrow Biopsy

26. Bone Marrow (BM) Biopsy Normal Aplastic

31. Anemia Check MCV MCV < 80 Microcytic anemia MCV 80 - 100 Normocytic anemia MCV > 100 Macrocytic anemia Defective synthesis of: Heme iron deficiency anemia anemia of chronic disease sideroblastic anemia lead poisoning Globin chains thalassemias HbE Fe

38. IRON DEFICIENCY ANEMIA

45. IRON DEFICIENCY ANEMIA Prevalence

51. IRON Body Compartments - 75 kg man 3 mg Absorption < 1 mg/day Excretion < 1 mg/day Stores 1000mg Tissue 500 mg Red Cells 2300 mg

59. Smooth tongue

61. BLOOD ROUTINE

64. IDA blood smear

65. IDA bone marrow

66. Normal store iron(blue)

67. IDA

68. Reticulocytes up

69. Using special stains such as methylene blue or brilliant cresyl blue, reticulocytes stain with dark blue granules whereas mature erythrocytes evenly stain pale blue.

74. Remember: Iron deficiency anemia is a manifestation of an underlying process. Look for and treat the cause of the iron deficiency.

77. The End