1 / 34

Red Blood Cell Disorders

Red Blood Cell Disorders. DR.Leni Lismayanti , SpPK-K Dept of Clinical Pathology RSHS/FKUP Bandung. Reference book:. Denise M Harmening. Clinical Hematology and Fundamental of Hemostasis. 5th edition. Philadelphia: FA Davis Co, 2009. RBC Structure & Function.

tala
Download Presentation

Red Blood Cell Disorders

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Red Blood Cell Disorders DR.Leni Lismayanti, SpPK-K Dept of Clinical Pathology RSHS/FKUP Bandung

  2. Reference book: • Denise M Harmening. Clinical Hematology and Fundamental of Hemostasis. 5th edition. Philadelphia: FA Davis Co, 2009.

  3. RBC Structure & Function • Areas of RBC metabolism important in normal RBC survival and function: • RBC membrane • Hb structure & function • RBC metabolic pathway

  4. RBC Membrane • RBC membran proteins: • Deformability • Permeability • RBC membran lipids: • Phospholipd • Glycolipid • cholesterol

  5. RBC membrane

  6. Abnormality That Can Lead to a Change in RBC Morphology

  7. Hb Structure & Function Hb function: delivery and release of oxygen to the tissue and facilitation of CO2 excretion. • Hb synhesis • depends on 3 prs: • Adequate Iron delivery & supply • Adequate synthesis of protophorphyrin • Adequate globin synthesis

  8. RBC Metabolic Pathway ATP needs for: • Hb function • Membrane integrity & deformability • RBC volume • Adequate amounts of reduced pyridine nucleotides • Protection of metabolic enzymes

  9. RBC Senescence & Hemolysis • RBC traveles 200-300 miles during 120 day life span  undergo the process of senescence (aging)  metabolic & physical changes. • 1% RBC taken out (removed) from circulation by RES/MPS  process: • Extravascular hemolysis (90%) • Intravascular hemolysis (5-10%)

  10. Extravascular Hemolysis

  11. Any questions?

  12. RBC Disorders: • Numbers: • Decreased (Anemia) • Increased (Polycythemia) • Structure and function: • Hemoglobin • RBC membrane • Abnormal erythropoiesis  nutritional RBC disorders  morphologic changes

  13. Anemia • Inability of the circulating blood pool to supply the tissue with adequate oxygen for proper metabolic function. • Clinically d/ based on: HT, SS, PE, Lab. • Caused by or associated with underlying disease. • Usually associated with decrease Hb & Hct (Lab: + RBC count). • Consideration by age, sex and other fact

  14. Classification of Anemia • Based on Hb level: • Moderate (7-10), severe (<7). • BM dynamic: • Hypoproliferative • Accelerated destruction • combination • Clinically (caused): • RBC indices (normochromic normocytic)

  15. Categories of anemia by causes • Blood loss • Accelerated destruction • Nutritional deficiency • BM replacement • Infection • Toxicity • Hematopoietic SC arrest/damage • Hereditary/acquired defect • idiopathic

  16. Significance of Anemia and Compensatory Mechanism • N: 1% of RBC loss daily  BM produce (measured by reticulocyte count  0.5-2.0%). • Replacement RBC requires: • Adequate functioning SC in BM • Normal RBC maturation process • Ability to release mature RBC from BM

  17. Proper HB & RBC production requires: • Variety of nutritional factors • Normal pathway of Bh synthesis • In severe anemias  symptoms of functional impairment of several organs (+). • Compensatory mechanism  increase 2,3-DPG levels

  18. 2,3-DPG • Physiologic regulator of: • Normal Hb oxygen-carrying capacity • Tissue oxygen delivery • 2,3-DPG (+)  Hb more readily released oxygen to tissues  depend on: pH & Oxygen level of arterial blood. • N individual responds to anemia  elevated EPO  Recombinant EPO  Th/ certain anemia.

  19. Lab Tests in Diagnosis of Anemia • Hb • Hct • (RBC Count) • RBC indices • Peripheral Blood Smear • Reticulocyte Count • BM smear/biopsy Treatment of anemia: depends on etiology

  20. Polycythemia • Polycythemia Vera (Myeloproliferative disorders). • Secondary Hypoxic Polycythemia (Secondary Erythrocytosis). • Relative Erythrocytosis.

  21. Any questions?

  22. RBC Morphology

  23. Thank You Very Much for Your Attention

More Related