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45-year old Singaporean man with lethargy and anaemia (normal or low…
45-year old Singaporean man with lethargy and anaemia
increase reticulocytes (>2.5%)
RBC destruction
or loss
Hemolysis
Congential
Acquired
Blood loss
Obvious
Occult
normal or low reticulocytes
RBC production defect
Microcytic
(Hb synthesis defect)
Iron deficiency
Bleeding from GI
GI problems
Malignancy
Rectal CA
Blood in stool
Tenesmus
Constipation
Small-diameter stools
Weight loss
Fever
Poorly-localised pain
Intra-abdominal malignancy
Gastric or esophageal malignancy
Peptic ulcer disease (benign)
Thalassemia (hereditary)
Sideroblastic anemia
Can be inherited or acquired
Often due to myelodysplasia
Macrocytic
(RBC synthesis defect)
B12/folate deficiency
Gastrectomy
Pernicious anemia
Liver disease
Drugs
Alcohol
Hypothyroid
Normocytic
Pancytopenia
aplastic anemia
Primary: acquired autoimmune cause
Secondary: drugs, toxins, radiation
malignant
infiltration
Bone marrow failure
decrease RBC alone
Renal disease: do not synthesise erythropoietin
Anaemia of
chronic disease
Rheumatoid arthritis
SLE
Neoplastic disorders
Chronic kidney disease
Chronic inflammation (infection: abcess, tuberculosis)
Pure RBC aplasia