Microcytic Anemia
Characteristics of microcytic anemia
What are small, abnormal RBCs with an MVC <80 fl?
Normocytic anemia is an anemia with this hallmark CBC finding
What is an MCV of 80-100 fL?
(normal RBC size)
Macrocytic anemia is defined by these features.
What are RBCs that are abnormally large with a CBC result of an MCV greater than 100 fL?
Hemolytic anemia is defined by this pathology
What is premature destruction of RBCs?
A full-term male infant is delivered via emergency cesarean section after a prolonged labor. At delivery, he is pale and with weak respirations. Exam shows tachycardia, hypotension, and poor perfusion. Fecal Occult Blood Test was positive. Labs were taken, results below:
Hemoglobin: 7 g/dL (low)
Hematocrit: 25% (low)
MCV: normal
Name the diagnosis.
What is acute hemorrhagic anemia?
The most common cause of infant nutritional deficiency
What is early introduction of cow's milk?
Two most common causes of normocytic anemia
What is chronic disease and acute bleed?
The most common type of macrocytic anemia
What is B12/folate deficiency anemia?
This congenital condition is a hemolytic anemia known for its distinct RBC shape and these CBC findings: low RBCs, low hematocrit, low hemoglobin and a possibility of increased WBCs, platelets
What is Sickle cell disease?
A six month old black baby presents at her six month child check with swollen hands and feet, jaundice, and mom reports she has had a blood curdling cry for three days now. Nothing she does makes it better. CBC lab results were as follows:
RBCs: 3.0 x10^12/l Low
Hb: 8.0g g/dl Low
Hct: 0.28 Low
MCV: 70 fl Low
MCH: 22 pg Low
MCHC:44 g/dL High
RDW: 11 Low
WBCs: 16,000 cells/mm^3 elevated
Plts:175,000 mcL lower end
What is sickle cell anemia?
This protein is elevated in cases of microcytic anemia
What is total iron-binding capacity?
The two most common acute causes of normocytic anemia in infants
What is birth trauma and GI bleed?
(normal at first then hgb/hct/platelets drop)
This thyroid condition is often associated with macrocytic anemia
What is hypothyroidism?
A 75 year old man presents to the ER with increased fatigue, a HR of 120 bpm, and occasional hematuria. You suspect anemia. His PMH includes an aortic valve replacement 10 years ago. His anemia is likely caused by this complication.
What is mechanical hemolysis?
(the valve is destroying the blood cells as they are passing through)
A 65-year-old woman is seen at her primary care office with a chief complaint of “yellow skin.” She reports fatigue and imbalance that deters her from physical activity, but has lost weight. She states that her family has said her personality has been “not quite right” for the past 2 years, but she thought she was “just getting old.” Patient’s tongue is smooth, tender, and red. CBC findings include a low hematocrit and hemoglobin, a high mean corpuscular volume, and pancytopenia.
What is the presentation of pernicious anemia?
A calculation of MCV/RBC to distinguish between iron deficient anemia and thalassemia?
What is the Mentzer index?
(>13 indicates iron deficient anemia, <13 indicates thalassemia)
This cancer, which accounts for approximately 30% of childhood cancers, causes chronic normocytic anemia in children due to its bone marrow suppression
What is acute lymphoblastic anemia?
(overcrowding of lymphoblasts in bone marrow = no room for RBC production)
These two underlying nutritional deficiencies are the most common causes of macrocytic anemia in 20-64 year olds
What is B12/folate deficiency and alcoholism?
A 6 day old baby’s CBC results include low hemoglobin and hematocrit, as well as neutropenia and thrombocytopenia. Mean corpuscular volume and red cell distribution width are high. Name the possible diagnosis.
What is hemolytic disease of the newborn (HDN)?
(Mom is Rh-neg, baby is Rh-pos, mom’s immune system attacks baby’s RBCs)
A 72-year-old woman with a history of chronic kidney disease presents with progressive fatigue and decreased ability to exercise. She denies blood in her stool. What is the likely type of anemia she is diagnosed with?
What is normocytic normochronic anemia/ anemia of chronic disease?
This genetic condition involves impaired synthesis of the globin protein component of hemoglobin often identified in early childhood
What is thalassemia?
CKD is a common cause of normocytic anemia in adults. As CKD progresses, kidney function decreases, resulting in a drop in production of this hormone (primarily produced in the kidney), which is responsible for stimulating the production of RBCs in bone marrow.
What is erythropoietin (EPO)?
A 60 year old man presents to the emergency room with signs and symptoms associated with anemia. During his history, it is reported that he has been a social drinker most of his life, but increased his weekly intake of alcohol over the past year after the death of his wife. He has a CBC done, which finds decreased Hgb and increased MCV. This is the most likely underlying cause of his macrocytic anemia.
What is alcoholism and liver disease?
This is the most common cause of acute renal failure in young children, which is generally caused by E. coli and shows severely low hemoglobin and thrombocytopenia (low platelets) on CBC analysis.
What is hemolytic uremia syndrome?
A 47 y.o. man comes into the ED with an acute GI bleed that began 20 minutes ago. What would we expect to see on a CBC collected upon his arrival, reflective of his hemorrhagic anemia?
What is a CBC that is WNL, barring underlying pathologies?