Anemia

Decrease in oxygen carrying capacity of blood.
Hb<13.5gm/dl in males
Hb<12.5gm/dl in females
Symptoms of anemias

Pallor - palms, conjunctiva
Fatigue
Lassitude
Weakness
Shortness of breath
Palpitations
Heart failure (high output type)

Types of Anemias

On the basis of mechanism

Blood Loss

Acute: trauma

Chronic: lesions of gastrointestinal tract, and genitourinary tract in females

Increased Destruction (Hemolytic Anemias)

Hereditary

Membrane abnormlities : Spherocytosis

Enzyme deficiencies : G6PD deficiency

Deficient globin synthesis: thalassemia syndromes

Structurally abnormal globin synthesis: sickle cell anemia, unstable hemoglobins

Acquired

Membrane defect: paroxysmal nocturnal hemoglobinuria

Antibody mediated

Isohemagglutinins: transfusion reactions, erythroblastosis fetalis (Rh disease of the newborn)

Autoantibodies: idiopathic (primary), drug-associated, systemic lupus erythematosus

Mechanical trauma to red cells

Microangiopathic hemolytic anemias: thrombotic thrombocytopenic purpura, disseminated intravascular coagulation

Infections: malaria

Impaired Red Cell Production

Disturbance of proliferation and differentiation of stem cells: aplastic anemia, anemia of renal failure

Defective DNA synthesis: deficiency or impaired utilization of vitamin B12 and folic acid (megaloblastic anemias)

Deficient heme synthesis: iron deficiency

Deficient globin synthesis: thalassemias

Unknown or multiple mechanisms: myelodysplastic syndrome, anemia of chronic inflammation, myelophthisic anemias due to marrow infiltrations

On basis of RBC morphology

the cell size (normocytic, microcytic, or macrocytic)
the degree of hemoglobinization-which is reflected in the color of the cells (normochromic or hypochromic)
the shape of the cells.

Anisocytosis - … different sizes

Poikilocytosis - … different shapes

Schistocytes - RBCs fragments

Echinocytes(burr cells) - RBCs with regular projections, seen in Renal disease

Acanthocytes(spur cells) - RBCs with irregular margins , seen in Liver disease

HEMOLYTIC ANEMIAS

ANEMIAS OF DECREASED RED CELL PRODUCTION

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