Our broad topic of anemia begins here
with laying down the foundation.
A lot to discuss, but we’ll
take it step by step.
First, anemia, who’s your patient?
Feeling fatigue and tired.
Why is that?
Well, for the most part, it’s
because of decreased hemoglobin.
That should be your focus here
in the first bullet point.
Hemoglobin by definition when decreased
automatically puts you in the realm of anemia.
Along with this,
oftentimes, you will find decrease
in total number of RBCs even though
there is not a guarantee and circulating
RBC mass is usually decreased as well.
Once again, by definition, anemia
means decreased hemoglobin,
which then means to you that you’re not
able to properly then deliver oxygen
to your tissues, which are now starving
and hungry, and so therefore, tired.
In addition, oftentimes,
with hemoglobin you’ll find that the
hematocrit will be decreased as well.
Hematocrit, you want to think
of approximately being 40%
and if you find something
much below 33 and such,
you know your patient is in the
realm of anemia most likely.
Next, now as we go through the synthesis
or the development of an RBC,
it’s important that keep a few
things in mind conceptually.
And if you think about
an RBC being generated,
it begins in the bone
marrow as you should now.
And if you begin in the bone marrow, you
should be thinking about the hematopoiesis
or specifically under hematopoiesis, it
would be erythropoiesis, wouldn’t it?
So in your head, you’re
thinking about what lineage,
if your thinking about the
bone marrow for RBCs?
The lineage here would be in
fact your myeloid, wouldn’t it?
So at some point, when we go on to
talk about more of your RBC pathology,
we’ll talk about more about
these myeloid issues.
I hope that’s clear.
All cells from your
hematopoietic stem cell
that are dealing with myeloid,
well, for the most part,
it will be all cells.
What are they?
RBCs, you also have your platelets,
but those are different types
of signalling pathways.
And then you have your
granulocytes and by that we mean,
of course, our neutrophils and
eosinophils and basophils.
And that’s about it
really in general,
and of course, macrophages as well, but
then you get into your non-myeloid
and that will be
I hope that’s clear.
That’s the picture that I’d like
for you to have in your head
prior to moving forward here.
Anemias, we’ll classify this, and
we will simply classify this,
but I’m then going to put in more
details for you, not to worry.
And we’ll begin our discussion at
some point with microcytic anemia.
And what that basically
means is the parameter
that you’re going to use
here is called MCV,
which stands for mean corpuscular volume
Once again, MCV stands for
mean corpuscular volume
and that is what you should be looking
for in interpretation of your labs
when you get them and you find
that your MCV is less than 80.
But before we go there,
understand what normal is,
normal is between 80 to 99.
Again, I am being specific there
and the reason for that is because
once you start getting above 100,
obviously that’s going to put you in
the category of macrocytic, okay?
So I am going to be a
little bit more technical.
But, you know, for the most part,
as far as your
hematology is concerned,
if you follow less than 80, you’ll
be fine, that’s microcytic.
If it’s between 80 to 100, it
will be called normocytic.
And then if it’s greater than 100, then
you’re thinking about macrocytic, okay?
And that’s the classification, that’s the
lab that you want to pay attention to.
As we move through some of
these specific anemias,
then I’m going to add in
more of our parameters
including red blood
cell distribution width
and I also put in here mean
corpuscular hemoglobin concentration,
and of course, the
RBC count and such.