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Anemia

Anemia
 Definition - Clinical signs of anemia - Classifications of anemias - 
Definition : Anemia is a reduction in the hematological findings 
( red cell count , Hb concentration and PCV ) 
below  normal range related to age , sex and breed 
Anemia is a symptom and not disease 
i.e anemia is not primary disease but it reflects of generalized disease process 


   Clinical signs of anemia
the clinical signs of anemia are the result of reduced oxygen - carrying capacity of the blood as well as the physiologic compensatory adjustments that occure to increase the efficiency of reduced circulating red cell mass and reduce work load of the heart 
1 - reduced exercise tolerance 
2 - pallor of mucous membranes
3 - increased heart rate 
4 - Increased respiratory rate 
5 - Depression 
6 - Icterus , hemoglobenemia , hemoglobinuria and fever are the signs of the acute hemolytic anemia .

Classifications of anemias

Anemias are classified according to Etiology , Erythrocyte Morphology and Bone marrow response 

A - Morphological classifications 

this classifications depends on MCV, MCH ,MCHC 

1 - Normocytic and normochromic anemia

Normal erythrocytes morphology ( MCV ,MCH ,MCHC are normal ) 
This type of animia is seen in the following 
- Chronic inflammation 
- Chronic renal disease 
- Chronic Liver disease 
- Chronic endocrine disease ( hyperthyroidism and hypoadrenocorticisim ) 
- A plastic and hypo plastic anemia 
- Malignancies
- Post acute hemolytic and hemorrhagic anemia 

2 - Normocytic hypochromic anemia 

Normal MCV and reduced of MCH and MCHC ( Early iron deficiency anemia )

3 - Macrocytic , normochromic anemia '

MCV and MCH  are increased whereas MCHC is normal 
This type of anemia is called megaloblastic which associated with pancytopenia 
- Vitamin B12 deficiency . 
- pernicious anemia 
- Folate deficiency 
- Cobalt deficiency 
- Congenital dyserythropoietic anemia 

4 - Macrocytic hypochromic anemia 

Increased MCV but MCH and MCHC are reduced 
This type of anemia is non- megaloblastic and not associated with pancytopenia .
This type of anemia is seen in the following 
- Reticulocytosis due to blood loss or hemolysis 
- Post spleenectomy 
- Pregnancy ( humans and primates ) 

5 - Microcytic hypochromic anemia 

MCV ,MCH and MCHC are reduced 

This type of anemia is seen in the following 
- Iron and Copper deficiencies 
- Chronic blood loss 
- Pyridoxine deficiency 
- Thalassemia 
- Sideroblastic anemia 

B - Etiology classification 

1 - Blood loss or hemorrhagic anemia 
2 - Hemolytic anemia 
3 - Nutritional deficiency anemias 
4 - Anemia resulting from disorders of DNA synthesis 

C- Classification  based on bone marrow response 

1 - Responsive or regenerative anemia 
- Acute blood loss 
- Acute hemolysis 

2 - Non responsive or non regenerative 

- A plastic and hypo plastic anemias 
- Chronic diseases

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