01-27-2018, 11:32 AM
They have a ↓ of Hemoglobin: Iron Deficiency, Anemia of Chronic Disease, Thalasemias (target cells), Lead Poisoning, Sideroblastic anemias
Remember Hemoglobin Molecule: Heme + globin . Heme = Iron + Protoporphirin. Globin: Alpha, Beta, Delta, Gamma.
Mechanism of Action: In Iron Deficiency No Iron to form Heme therefore it is not Hemoglobin. Serum Iron and frerritin ↓, TIBC ↑
Anemia of Chronic Disease same mechanism of Iron Deficiency. But the Iron deposit (Ferritin) is ↑ (macrophages in bone marrow)
Sideroblastic Anemia: We must do a Bone Marrow Bx with Pursian Stain to do the sideroblastic disc.
Sideroblastic Anemia: Causes: 1) Alcohol, 2) B6 Deficiency, 3) Lead Poisoning (denature protein).
Thalasemias: Alpha (Asian and Black) Autosomal Recessive. Alpha globin chain problem. Hemoglobin Electrophoresis is Normal
Thalasemias: Do not given the IRON in alpha
Thalasemias: Betha (Black, Greek and Italian) Stop Codon. It wil show in Hemoglobin Electrophoresis. NSTx in mild case is nothing
Vit B6 Deficiency: Microcytic Hypochromic, Increase Fe+ in Mitochondria, like Lead Poisoning also shows Ringed sideroblasts in bone marrow.
Vit B6 Deficiency: Lab. Result are: Protoporphyrin and Gamma-ALA: Decreased; Ferritin and Serum Iron: Increased
Vitamin B6 (Piridoxine) Deficiency
** Microcytic Hypochromic
** Increase Iron in Mitocondria
** Ringed Sideroblasts in Bone Marrow
** Can not have Porphyrin
** Protoporphyrin: ↓
** Gamma-ALA: ↓
** Ferritin: ↑
** Serum Iron: ↑
CAUSES
** Isoniazid for tuberculosis. Antidote Vit B6
Iron Deficiency
** Microcytic Hypochromic
** No Iron in Mitocondria
** No Ringed Sideroblasts in Bone Marrow
** Iron is not inserted in Prophyrin
** Protoporphyrin: ↑
** Gamma-ALA: Normal
** Ferritin: ↓
** Serum Iron: ↓
CAUSES
** Direct iron insufficient to compensate for normal loss
Lead Poisoning
** Microcytic
** Coarse basophilic stippling in erythrocytes
** Ringed Sideroblasts in Bone Marrow
** Iron is not inserted in Prophyrin
** Protoporphyrin: ↑
** Gamma-ALA: ↑
** Ferritin: ↑
** Serum Iron: ↑
CAUSES
** Lead paint, Pottery glaze, batteries.
Dx: Measuring blood lead levels.
Remember Hemoglobin Molecule: Heme + globin . Heme = Iron + Protoporphirin. Globin: Alpha, Beta, Delta, Gamma.
Mechanism of Action: In Iron Deficiency No Iron to form Heme therefore it is not Hemoglobin. Serum Iron and frerritin ↓, TIBC ↑
Anemia of Chronic Disease same mechanism of Iron Deficiency. But the Iron deposit (Ferritin) is ↑ (macrophages in bone marrow)
Sideroblastic Anemia: We must do a Bone Marrow Bx with Pursian Stain to do the sideroblastic disc.
Sideroblastic Anemia: Causes: 1) Alcohol, 2) B6 Deficiency, 3) Lead Poisoning (denature protein).
Thalasemias: Alpha (Asian and Black) Autosomal Recessive. Alpha globin chain problem. Hemoglobin Electrophoresis is Normal
Thalasemias: Do not given the IRON in alpha
Thalasemias: Betha (Black, Greek and Italian) Stop Codon. It wil show in Hemoglobin Electrophoresis. NSTx in mild case is nothing
Vit B6 Deficiency: Microcytic Hypochromic, Increase Fe+ in Mitochondria, like Lead Poisoning also shows Ringed sideroblasts in bone marrow.
Vit B6 Deficiency: Lab. Result are: Protoporphyrin and Gamma-ALA: Decreased; Ferritin and Serum Iron: Increased
Vitamin B6 (Piridoxine) Deficiency
** Microcytic Hypochromic
** Increase Iron in Mitocondria
** Ringed Sideroblasts in Bone Marrow
** Can not have Porphyrin
** Protoporphyrin: ↓
** Gamma-ALA: ↓
** Ferritin: ↑
** Serum Iron: ↑
CAUSES
** Isoniazid for tuberculosis. Antidote Vit B6
Iron Deficiency
** Microcytic Hypochromic
** No Iron in Mitocondria
** No Ringed Sideroblasts in Bone Marrow
** Iron is not inserted in Prophyrin
** Protoporphyrin: ↑
** Gamma-ALA: Normal
** Ferritin: ↓
** Serum Iron: ↓
CAUSES
** Direct iron insufficient to compensate for normal loss
Lead Poisoning
** Microcytic
** Coarse basophilic stippling in erythrocytes
** Ringed Sideroblasts in Bone Marrow
** Iron is not inserted in Prophyrin
** Protoporphyrin: ↑
** Gamma-ALA: ↑
** Ferritin: ↑
** Serum Iron: ↑
CAUSES
** Lead paint, Pottery glaze, batteries.
Dx: Measuring blood lead levels.