... Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 1) Harrison's Internal Medicine > Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss Definitions ... classification of anemias comprises three groups: decreased production of red cells, increased destruction of red cells, and acuteblood loss. Red cell destruction and acute loss, both associated ... Physical loss of red cells from the bloodstream—which in most cases also means physical loss from the body—is fundamentally different from destruction of red cells within the body. Therefore the clinical...
... hemoglobinuria, often associated with hemosiderinuria and an Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 2) Table 101-2 General Features of Hemolytic Disorders General ... gradual loss of cellular organelles and of biosynthetic abilities. In the end the erythroid cell undergoes a process that has features of apoptosis, including nuclear pyknosis and actual loss ... reticulocytes is associated with an increased mean corpuscular volume (MCV) in the blood count. On the blood smear this is reflected in the presence of macrocytes; there is also polychromasia...
... Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 3) Figure 101-1 cause considerable iron loss, needing replacement. With chronic extravascular ... "decompensated"—i.e., anemia may suddenly appear—in certain circumstances for instance, pregnancy, folate deficiency, renal failure interfering with adequate EPO production, or an acute infection ... except there is no anemia. This notion is important from the diagnostic point of view, because a patient with a hemolytic condition, even an inherited one, may present without anemia. It is also...
... severe forms are instead autosomal recessive (with the patient being homozygous). Figure 101-3 Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 5) Hemolytic Anemias ... intimately. Figure 101-2 Diagram of red cell membrane/cytoskeleton. (For explanation see text.) (From N Young et al: Clinical Hematology. Copyright Elsevier, 2006; with permission.) ... perpendicular to or lying across the membrane; they include ion channels, receptors for complement components, receptors for other ligands, and some of unknown function. The most abundant of these...
... Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 6) Peripheral blood smear from patients with membrane-cytoskeleton abnormalities. ... (dominant) Mutations of this gene account for ~30% of HE, including some severe forms. ANK1 8p11.2 Ankyrin HS (dominant) May account for majority of HS. SLC4A1 17q21 Band 3 ... α-Spectrin HS (recessive) Rare. HE (dominant) Mutations of this gene account for about 65% of HE. More severe forms may be due to coexistence of an otherwise silent mutant allele. SPTB...
... Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 7) Clinical Presentation and Diagnosis The spectrum of clinical severity of HS is broad. Severe ... severe anemia, whereas mild cases may present in young adults or even later in life. In women, HS is sometimes first diagnosed when anemia is investigated during pregnancy. The main clinical ... sorts of bizarre poikilocytes may predominate (Fig. 101-3B, C). Clinical features and recommended management are similar to those for HS. Although the spleen may not have the specific role it...
... Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 8) Abnormalities of the Glycolytic Pathway (Fig. 101-1) Since ... exclusively on the anaerobic portion of the glycolytic pathway for producing energy in the form of ATP. Most of the ATP is required by the red cell for cation transport against a concentration gradient ... is made in young adults for instance, in a woman during her first pregnancy, when the anemia may get worse. In part the delay in diagnosis is due to the fact that the anemia is remarkably well-tolerated...
... anemia (CNSHA; see below) are a discrete subset. This much more severe clinical phenotype can be ascribed in some cases to adverse qualitative changes (for instance, a decreased affinity for ... exchange transfusion; if the anemia is less severe, it may present later in life or may even remain asymptomatic and be detected incidentally when a blood count is done for unrelated reasons. The ... already known in the family, then of course one could test directly for that defect at the DNA level, bypassing the need for enzyme assays. Abnormalities of Redox Metabolism G6PD Deficiency...
... of comorbidity, full recovery from acute HA associated with G6PD deficiency is the rule. Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 10) Epidemiology G6PD ... hemolysis. The most serious threat from acute HA in adults is the development of acute renal failure (exceedingly rare in children). Once the threat of acuteanemia is over, and in the absence of ... Disease, 8th edition. New York, McGraw-Hill, 2001.] Clinical Manifestations The vast majority of people with G6PD deficiency remain clinically asymptomatic throughout their lifetime. However,...
... trigger can be Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 11) Table 101-5 Drugs that Carry Risk of Clinical Hemolysis in Persons with G6PD Deficiency Definite ... Favism Acute Destruction of older fraction of G6PD-deficient red G6PD assay Triggered by ingestion of large dish of fava beans; but trigger can be Chapter 101. Hemolytic Anemias and Anemia ... Clostridium perfringens be responsible Microangiopathic Acute or chronic Red cell fragmentation Red cell morphology on blood smear Different causes ranging from endothelial damage...
... often referred to as screening tests, which are suitable for population Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 12) Figure 101-6 hemodialysis may be ... chronic in these patients, they are also vulnerable to acute oxidative damage, and therefore the same agents (see Table 101-5) that can cause acute HA in people with the ordinary type of G6PD deficiency ... present with anemia or unexplained jaundice, or because of gallstones later in life. The spleen may be enlarged. The severity of anemia ranges from borderline to transfusion-dependent. The anemia...
... contaminated blood unit. Occasionally HA is seen, especially in children, with sepsis or endocarditis from a variety of organisms. Chapter 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss ... third in frequency among red cell enzyme defects (after G6PD deficiency and PK deficiency). The anemia is lifelong, of variable severity, and may benefit from splenectomy. Familial Hemolytic ... external to drumming. The other situation, which has been called microangiopathic hemolytic anemia, (Table 101-6) is chronic and iatrogenic; it takes place in patients with prosthetic heart...
... 101. Hemolytic Anemias and Anemia Due to AcuteBloodLoss (Part 14) Autoimmune Hemolytic Anemia (AIHA) Except for countries where malaria is endemic, AIHA is the most common form of acquired ... Hemolytic Anemia: Treatment Mechanism of antibody-mediated immune destruction of red cells. (From N Young et al: Clinical Hematology. Copyright Elsevier, 2006; with permission.) Clinical ... transplantation has been used, sometimes successfully. report or for which the physician must test. The diagnostic test for AIHA is the antiglobulin test worked out in 1945 by R.R.A. Coombs...
... be used as the sole criteria for determining the need for surgical interven-tion, but rather should be used as an objective tool for confirming the diagnosis of CRS and for surgi cal plan-ning. ... Allergy, Asthma & Clinical Immunology 2011, 7:2http://www.aacijournal.com/content/7/1/2Page 35 of 38 REVIEW Open AccessCanadian clinical practice guidelines for acute and chronic rhinosinusitisMartin ... society.In Canada, 2.89 million prescriptions were dispensed for acute rhinosinusitis (ARS) or CRS in 2006, withapproximately 2/3 for ARS and 1/3 for CRS [3]. Despitewell-established differences betwe...