Pernicious Anemia

Pernicious Anemia

Clinical and laboratory Findings

1- Neurological manifestations in the form of peripheral neuropathy with degeneration of the spinal cord

2- Complete blood count (CBC).

( Hb concentration , RBCs count and PCV are reduced )

Increased MCV and MCH with normal MCHC ( Macrocytic normochromic anemia )

3 - Blood film shows macrocytes with fully hemoglobinization , Anisocytosis , Poikylocytosis

4 - Shift to right , ( the neurophils are hypersgmented )

5 - Pancytopenia

6 - Howell jolly bodies are present .

7 - Bone marrow characterized by the presence of large megaloblastic erythroid cells and large giant metaamyelocytes and hypersegmented neutrophils . ALSO M/E ratio is reduced

8 - Serum B12 level is decreased

9 - Increased Urinary excration of methylmalonat .

10 - Presence of internsic factor and parietal cell antibodies in serum and in gastric juice

Comments

MICROSCOPIC URINALYSIS

MICROSCOPIC URINALYSIS Methodology A sample of well-mixed urine (usually 10-15 ml) is centrifuged in a test tube at relatively low speed (about 2-3,000 rpm) for 5-10 minutes until a moderately cohesive button is produced at the bottom of the tube. The supernatant is decanted and a volume of 0.2 to 0.5 ml is left inside the tube. The sediment is resuspended in the remaining supernatant by flicking the bottom of the tube several times. A drop of resuspended sediment is poured onto a glass slide and coverslipped.

Liver Enzymes

Liver Enzymes Definition A liver enzyme is a protein that helps to speed up a chemical reaction in the liver. Liver function tests are blood tests that are used to evaluate various functions of the liver - for example, metabolism, storage, filtration and excretion, which are often performed by liver enzymes. However, not all liver function tests are measures of enzyme function. • ALT - (alanine aminotransferase ) - was previously called SGPT is more specific for liver damage. The ALT is an enzyme that is produced in the liver cells (hepatocytes) therefore it is more specific for liver disease than some of the other enzymes. It is generally increased in situations where there is damage to the liver cell membranes. All types of liver inflammation can cause raised ALT. • AST - (aspartate aminotransferase) which was previously called SGOT. This is a mitochondrial enzyme that is also present in heart, muscle, kidney and brain ...

Gamma globulins

Gamma globulins Increased in immunoglobulins are often referred to as hyper gammaglobulinemia or gammopathies Hypogammaglobulinemia This most often results from decreased synthesis , but could also be associated with increased loss . 1 - Decreased synthesis ( High A : G ratio ) a- failure of passive transfer or colostrum deprivation b - Combined immunodeficiency disease ( Both T & B cells are deficient ) c - Agammaglobulinemia d - Acquired deficiency associated with inflammation , immunosuppressive drugs or neoplasia

Interpretation Of Lab Results

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