Page 303 - Concise Pathology for Exam Preparation ( PDFDrive )

288 SECTION II Diseases of Organ Systems

2. Morphological classification of anaemia
(a) Microcytic hypochromic anaemia (MCV , 80 fL; MCH , 27 pg)
(b) Macrocytic normochromic anaemia (MCV .100 fL; MCH within normal range)
(c) Normocytic normochromic anaemia (MCV 80–100 fL; MCH within normal range)
Symptoms of Anaemia

Acute:
Shortness of breath, organ failure and shock
Chronic:
1. General symptoms (due to tissue hypoxia)
• Fatigue, lassitude, dyspnoea, palpitations, dizziness, headache, syncope, tinnitus and
vertigo
• Irritability, sleep disturbances, lack of concentration and paraesthesias
• Anorexia, nausea and bowel disturbances
• Symptoms of cardiac failure
• Amenorrhea and polymenorrhea
2. With haemolysis: Skeletal abnormalities (due to expansion of marrow), growth retarda-
tion, jaundice and gallstones
3. With defective erythropoiesis: Iron overload leading to heart and endocrine failure
Signs of Anaemia

• Pallor of skin and mucous membranes, nail beds and palpebral conjunctivae
• Tachycardia with a wide pulse pressure, ejection systolic murmur; best heard over the
pulmonary area
• Cardiac dilatation and later, signs of cardiac failure
• Oedema

Morphological abnormalities of red cells in different types of anaemias are described in
Table 12.4.

TABLE 12.4. Morphological abnormalities of red cells in different types of anaemias
Abnormalities Description Morphology
Polychromato- Red cells staining bluish-grey; they represent young reticu-
philia or locytes and are seen in the conditions associated with
polychromasia accelerated erythropoiesis

Punctate baso- Presence of fine or coarse purple-blue granules in the cy-
philia or toplasm of red cells, representing ribosomal aggregates
basophilic Causes: b-Thalassaemia, haemoglobinopathies, lead and
stippling arsenic poisoning

Anisocytosis Variation in size of the cell as seen in iron deficiency
Microcytes Small red cells (MCV , 80 fL) with decreased amount of
haemoglobin.
Causes: Iron deficiency anaemia, thalassaemia, anaemia of
chronic disease, lead poisoning and sideroblastic anaemia
Macrocytes Large red cells (MCV . 100 fL; size . 8.5 microns,
normal MCH). May be round or oval
Causes: Impaired DNA synthesis (B 12 and folate deficiency),
accelerated erythropoiesis, excessive surface membrane
(liver disease or splenectomy)
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