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Summary Haematological changes in Systemic Disease
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Haematological Changes in Systemic DiseaseRange of Haematological change
Soluble Factors
Raised FVIII in Inflammation -> Thrombosis risk
Erythrocytes
Raised: Altitude/hypoxia or Epo secreting tumour
Reduced: Bone marrow (BM) failure or deficiency (Vit B12 or Iron) or Shortened
survival
Platelets
Raised: Bleeding, Inflammation, Splenectomy
Reduced: BM failure or deficiency or Shortened survival e.g., Immune thrombocytopenic
Purpura or Thrombotic Thrombocytopenic Purpura
Leucocytes
Raised: Infection, Inflammation, Corticosteroids
Reduced: BM failure or deficiency
Erythrocytes
Anaemia associated with Malignancy or Systemic Disease
Anaemia may be the FIRST presentation of occult malignancy
Fe deficiency
Leucoerythroblastic anaemia
Haemolytic Anaemia
Anaemia of Inflammation/ Of Chronic Disease
Fe deficiency Anaemia
Laboratory Findings
Microcytic hypochromic anaemia
Reduced ferritin, transferrin saturation
Raised Total Iron Binding Capacity (TIBC)
Bleeding until proven otherwise
Often menorrhagia in pre-menopausal women
Blood loss in men and post-menopausal women
Occult Blood Loss
GI Cancers -> Gastric, Colonic/Rectal
Urinary Tract Cancers -> Renal Cell Carcinoma, Bladder Cancer
Blood Film
Hypochromatic RBCs
Anisocytosis and Poikilocytosis
Leuco-Erythroblastic Anaemia
, Anaemia characterized by the presence of nucleated erythrocytes and early myeloid cells in
the peripheral blood
Variable degree of anaemia
Blood Film
Teardrop RBCs (Plus Anisocytosis and Poikocytosis)
Nucleated RBCs
Immature Myeloid Cells
Causes
Haemolytic Anaemia-Two Groups
Primary (Inherited)- Defects of the red cell
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