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HEMOLYTIC ANEMIAS

HEMOLYTIC ANEMIAS. SHEIKHA. Premature destruction of the red cells. HEMOLYTIC ANEMIAS. Abnormalities of the Red Cells. Abnormalities of the Environment of the Red Cells. SHEIKHA. HEMOLYTIC ANEMIAS. Abnormalities of the Red Cells. SHEIKHA. HEMOLYTIC ANEMIAS. Membrane. Hb.

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HEMOLYTIC ANEMIAS

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  1. HEMOLYTIC ANEMIAS SHEIKHA

  2. Premature destruction of the red cells HEMOLYTIC ANEMIAS Abnormalities of the Red Cells Abnormalities of the Environment of the Red Cells SHEIKHA

  3. HEMOLYTIC ANEMIAS Abnormalities of the Red Cells SHEIKHA

  4. HEMOLYTIC ANEMIAS Membrane Hb Enzymes 120 days SHEIKHA

  5. HS HEMOLYTIC ANEMIAS Membrane HE Hb H. Stomatocytosis Enzymes SHEIKHA

  6. HS HEMOLYTIC ANEMIAS Membrane HE H.St. Hb Enzymes Hemoglobinopathies Thalassemia Sickle SHEIKHA

  7. HS HEMOLYTIC ANEMIAS Membrane HE H.St. Hb G6PDH ↓ Enzymes Hemoglobinopathies PK ↓ Thalassemia Sickle ALL CONGENITAL SHEIKHA

  8. HEMOLYTIC ANEMIAS PNH Paroxysmal Nocturnal Hemoglobinuria ACQUIRED SHEIKHA

  9. HEMOLYTIC ANEMIAS Abnormalities of the Environment of the Red Cells SHEIKHA

  10. Abnormal Plasma Constituents IMMUNE: DRUGS HDN TOXINS Drugs AIHA Abnormal Physical Environment Fragmentation Hypersplenism Burn HEMOLYTIC ANEMIAS due to ABNORMAL RBC ENVIRONMENT Infections Malaria Cl. Welchii WARM CHAD SHEIKHA

  11. Abnormal Plasma Constituents IMMUNE: DRUGS HDN TOXINS Drugs AIHA HEMOLYTIC ANEMIAS due to ABNORMAL RBC ENVIRONMENT WARM CHAD SHEIKHA

  12. Abnormal Plasma Constituents IMMUNE: HDN Drugs AIHA HEMOLYTIC ANEMIAS due to ABNORMAL RBC ENVIRONMENT IMMUNE HEMOLYTIC ANEMIAS WARM CHAD SHEIKHA

  13. Abnormal Plasma Constituents IMMUNE: DRUGS HDN TOXINS Drugs AIHA HEMOLYTIC ANEMIAS due to ABNORMAL RBC ENVIRONMENT AIHA WARM IDIOPATHIC Associated with: SLE CLL LYMPHOMA OTHER AUOIMMUNE DISORDERS MISCELANEOUS WARM CHAD SHEIKHA

  14. HEMOLYTIC ANEMIAS Coomb’s Test SHEIKHA

  15. Abnormal Plasma Constituents IMMUNE: DRUGS HDN TOXINS Drugs AIHA HEMOLYTIC ANEMIAS due to ABNORMAL RBC ENVIRONMENT AIHA CHAD ACUTE CHRONIC ATYPICAL MYCO- PLASMA PNEMONIA IM IDIO- PATHIC LYMPH- OMA WARM CHAD SHEIKHA

  16. Abnormal Plasma Constituents IMMUNE: DRUGS HDN TOXINS Drugs AIHA HEMOLYTIC ANEMIAS due to ABNORMAL RBC ENVIRONMENT AIHA WARM CHAD PCH CHRONIC Idiopathic ACUTE Measles Mumps Flu Idiopathic WARM CHAD SHEIKHA

  17. Management of AIHA • STEROID • SPLENECTOMY • RITUXIMAB • CYCLOSPORIN • FOLATE

  18. Abnormal Physical Environment Fragmentation Hypersplenism Burn HEMOLYTIC ANEMIAS due to ABNORMAL RBC ENVIRONMENT March Hb-uria MAHA Microangiopathic Hemolytic Anemia Malignancy “Mucin Secreting Adeno- Carcinoma” Abnormal Blood Vessels TTP/ HUS Thrombotic Thrombocytopenic Purpura / Hemolytic Uremic Syndrome Septicemia Mechanical HA From damaged Valves Malignant HTN SHEIKHA

  19. HEMOLYTIC ANEMIAS due to ABNORMAL RBC ENVIRONMENT Infections Malaria Cl. Welchii SHEIKHA

  20. Abnormal Plasma Constituents IMMUNE: DRUGS HDN TOXINS Drugs AIHA Abnormal Physical Environment Fragmentation Hypersplenism Burn HEMOLYTIC ANEMIAS due to ABNORMAL RBC ENVIRONMENT Infections Malaria Cl. Welchii WARM CHAD SHEIKHA

  21. HEMOLYTIC ANEMIAS SHEIKHA

  22. HEMOLYTIC ANEMIAS LABORATORY FINDINGS: Hyperbilirubinemia“mild & unconjugated” Anemia Increased Urinary Urobilinogen Reduced Haptoglobin Reticulocytosis & Polychromasia Increased Marrow Activity RBC shape changes: Spherocytosis Fragmentation SHEIKHA

  23. CLINICAL FEATURES Jaundice “usually mild” Pallor Acholuric jaundice Splenomegaly Gall stones Leg ulcers Crises: HEMOLYTIC ANEMIAS Aplastic Hemolytic Sequestration SHEIKHA

  24. CLINICAL FEATURES Jaundice “usually mild” Pallor Acholuric jaundice Splenomegaly Gall stones Leg ulcers HEMOLYTIC ANEMIAS LABORATORY FINDINGS: Hyperbilirubinemia Anemia Increased Urinary Urobilinogen Reduced Haptoglobin Reticulocytosis & Polychromasia Increased Marrow Activity RBC shape changes SHEIKHA

  25. HEMOLYTIC ANEMIAS Intravascular Hemolysis Hemoglobinemia Hemoglobinuria Hemosiderinuria SHEIKHA

  26. Hemoglobinuria HEMOLYTIC ANEMIAS SHEIKHA

  27. Hemosiderinuria HEMOLYTIC ANEMIAS SHEIKHA

  28. HEMOLYTIC ANEMIAS SHEIKHA

  29. HEMOLYTIC ANEMIAS SHEIKHA

  30. HEMOLYTIC ANEMIAS SHEIKHA

  31. HEMOLYTIC ANEMIAS SHEIKHA

  32. HEMOLYTIC ANEMIAS SHEIKHA

  33. HEMOLYTIC ANEMIAS SHEIKHA

  34. HEMOLYTIC ANEMIAS SHEIKHA

  35. HEMOLYTIC ANEMIAS SHEIKHA

  36. Hereditary Spherocytosis HEMOLYTIC ANEMIAS SHEIKHA

  37. HEMOLYTIC ANEMIAS SHEIKHA

  38. HEMOLYTIC ANEMIAS SHEIKHA

  39. HEMOLYTIC ANEMIAS SHEIKHA

  40. HEMOLYTIC ANEMIAS SHEIKHA

  41. HEMOLYTIC ANEMIAS SHEIKHA

  42. HEMOLYTIC ANEMIAS SHEIKHA

  43. HEMOLYTIC ANEMIAS Hereditary Elliptocytosis SHEIKHA

  44. MANAGEMENT OF HS OPSI PNEUMOVAX Hib SPLENECTOMY Folate

  45. HEMOLYTIC ANEMIAS SHEIKHA

  46. HEMOLYTIC ANEMIAS Glucose 6 Phosphate Dehydrogenase Deficiency SHEIKHA

  47. Glucose 6 Phosphate Dehydrogenase Deficiency HEMOLYTIC ANEMIAS Sex-linked 200 million Middle East Mediterranean Africa Saudis 13% Kurds 40%Suly Study 6% Malaria protection SHEIKHA

  48. Glucose Glycolysis Embden-Meyerhof Pathway G-6-P F-6-P F 1,6 DP DHAP Ga3P 1,3 DPG 3 PG 2 PG PEP Lactate Pyruvate SHEIKHA

  49. Glucose ATP Glycolysis ADP G-6-P F-6-P F 1,6 DP ATP ADP OXIDATIVE DAMAGE DHAP Ga3P 1,3 DPG 3 PG 2 PG PEP Lactate Pyruvate ADP ATP ATP ADP ATP SHEIKHA

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