Normocytic anemias

1. Aplastic anemia

1. dysfunctional or deficient multipotent myeloid stem cells leads to pancytopenia

2. caused by viruses (CMV), radiation, renal failure (decreased erythropoietin)

3. drugs (NSAIDs, benzene, chloramphenicol)

2. Acute blood loss

1. transient normocytic anemia

3. Hemolytic anemia

1. increased RBC destruction
2. leads to increase unconjugated bilirubinemia, hemoglobinemia/uria, decreased haptoglobin
3. increase in retic count secondary to erythropoiesis
4. infections bartonellosis, clostridia, malaria
5. genetic (intracorpuscular) hemolytic anemias

• hereditary ovalocytosis (autosomal dominant)

• hereditary spherocytosis (autosomal dominant) defect in spectrin protein in ECM

• G-6-PD (x-linked) precipitated by oxidative stress, see Heinz bodies

• Pyruvate kinase def (autosomal recessive)

6. acquired (extracorpuscular) hemolytic anemias

• lymphoma, spherocytosis = (+) direct Coomb’s test

• lymphoid neoplasm, ABO incompatibility, Raynaud’s phenomenon = (+) indirect Coomb’s test
  

Category: Pathology Notes