Day: April 27, 2024

Macrocytic Anaemia This is an anaemia with MCV > 100um3, most commonly due to folate or Vitamin B12 deficiency.– These are needed to make DNA which is needed for cell division. Causes of macrocytic anaemia can be remembered by the acronym FAT RBC MC: Foetus Alcohol excess Thyroid (hypothyroid) Reticulocytosis (due to haemolytic anaemia as RBC precursors are bigger) B12/folate deficiency Cirrhosis (liver) Myeloproliferative disorders –> precursors are bigger than RBC so increase average volume Cytotoxic drugs (e.g. 5-fluorouracil)   Folate deficiency This is found in green leafy vegetables, nuts and liver and is absorbed in the jejunum. – The deficiency leads to

Microcytic Anaemia A problem in haemoglobin results in the improper folding in RBC leading to a reduced cell mass. – Due to the structure of haemoglobin, it is caused by deficits in haem group or Hb chains themselves.   Iron Deficiency Anaemia (IDA) This is a microcytic anaemia which occurs due to decreased levels of iron, most common worldwide.   Causes: – Blood loss –> GI bleeding or menstruation (seen in 14% of women) – Poor diet –> seen in babies or children – Malabsorption –> coeliac disease, due to inflammation of the small bowel   Symptoms: – General signs

Anaemia: Overview Anaemia is defined as a low haemoglobin (Hb) concentration, which can be either due to a reduced RBC mass or increased plasma volume (e.g. in pregnancy) – It is <135g/L for men and <115g/L for women – Subdivided by the mean corpuscular volume (MCV) into microcytic (MCV<80um3), normocytic (80-100) and macrocytic (MCV > 100).   Symptoms: – Weakness, fatigue and dyspnea – Pale conjunctiva and skin – Headaches + light headedness – Angina –> especially if there is pre-existing coronary artery disease (+ aortic flow murmur) – Can be signs of a hyperdynamic circulation due to compensation (tachycardia,