Regenerative and Non-Regenerative Anaemias - Revision history

Fiorecastro: /* Haemorrhage */

2022-04-11T16:55:06Z

Haemorrhage

Show changes

Fiorecastro: /* Haemolysis */

2022-03-16T13:13:53Z

Haemolysis

Fiorecastro: /* Haemorrhage */

2022-03-16T13:09:21Z

Haemorrhage

JoeWright at 08:56, 16 March 2022

2022-03-16T08:56:11Z

Fiorecastro at 17:03, 15 March 2022

2022-03-15T17:03:46Z

Fiorecastro at 16:52, 15 March 2022

2022-03-15T16:52:37Z

JoeWright at 10:12, 8 March 2022

2022-03-08T10:12:23Z

Fiorecastro: /* Infections */

2022-03-07T20:53:36Z

Infections

Fiorecastro at 20:52, 7 March 2022

2022-03-07T20:52:15Z

Fiorecastro: /* Non-regenerative Anaemia */

2022-03-07T20:44:17Z

Non-regenerative Anaemia

@@ Line 85: / Line 85: @@
 * Haemolytic anaemias often result in a degree of hyperbilirubinaemia which, if sufficiently severe, will be evident as icterus. RBC destruction leads to an increased level of unconjugated bilirubin which exceeds the rate of hepatic excretion. Acute severe anaemia may also cause hypoxic or toxic hepatic injury, resulting in decreased bilirubin metabolism and cholestasis. Although hyperbilirubinaemia results primarily from increased unconjugated bilirubin, conjugated bilirubin also increases and leads to bilirubinuria. Evaluation of unconjugated versus conjugated bilirubin is often not helpful when trying to differentiate between pre-hepatic and hepatic jaundice.
-References: [[NationWide Laboratories]]
+Haemolysis References: [[NationWide Laboratories]]
 Haemolysis may occur in the following processes:
@@ Line 96: / Line 96: @@
 *'''Hypophosphataemia''' which occurs in post-parturient cattle (causing post-parturient haemoglobinuria), with refeeding syndrome and when animals with [[Diabetes Mellitus|diabetes mellitus]] are stabilised with insulin.
 *Exposure to '''toxins''' including rape and kale (which contain SMCO radicals) in cattle, onions and garlic in dogs and paracetamol in cats.
-*'''Microangiopathic anaemia''' which occurs when red blood cells are forced through small meshworks of fibrin as with [[Haemangiosarcoma|haemangiosarcomas]], [[Disseminated Intravascular Coagulation|disseminated intravascular coagulation]] (DIC) or bacterial endocarditis.This is usually a mild, often subclinical anaemia unless there is concurrent haemorrhage from, for example, a tumour. RBCs are damaged as they pass through abnormal vessels or regions of turbulent blood flow, giving rise to schistocytes. These fragmented red cells are phagocytosed by the mononuclear phagocytic system, causing anaemia. Numerous schistocytes in a smear are always significant. References: [[NationWide Laboratories]]
+*'''Microangiopathic anaemia''' which occurs when red blood cells are forced through small meshworks of fibrin as with [[Haemangiosarcoma|haemangiosarcomas]], [[Disseminated Intravascular Coagulation|disseminated intravascular coagulation]] (DIC) or bacterial endocarditis.
 Haemolysis usually results in a more strongly regenerative response than haemorrhage and can be differentiated by plasma protein concentrations; these will fall with haemorrhage, but not with haemolysis.
@@ Line 117: / Line 118: @@
 '''Proliferative disorders.''' Can also cause nonregenerative anaemia as neoplastic cells over-run the bone marrow (myelophthisic disease).
-References: [[NationWide Laboratories]]
+Primary Anaemia References: [[NationWide Laboratories]]
 '''[[Immune Mediated Haemolytic Anaemia|Pure red cell aplasia]]'''
@@ Line 133: / Line 134: @@
 '''FIV.''' May be associated with nonregenerative anaemia possibly with concurrent neutropaenia.
-References: [[NationWide Laboratories]]
+Infections References: [[NationWide Laboratories]]
 === Secondary Anaemia ===
@@ Line 144: / Line 145: @@
 '''Hypothyroidism and hyperadrenocorticism.''' These endocrinopathies may result in mild, clinically insignificant anaemia.
-References: [[NationWide Laboratories]]
+Secondary Anaemia References: [[NationWide Laboratories]]
 === Iron Deficiency Anaemia ===

@@ Line 63: / Line 63: @@
 Increased blood urea nitrogen with normal serum creatinine can be seen with gastrointestinal haemorrhage.
-References: [[NationWide Laboratories]]
+Haemorrahge References: [[NationWide Laboratories]]
 Any form of spontaneous haemorrhage with no apparent cause may suggest the presence of an underlying coagulopathy.  The most common haemorrhagic presentations are:

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 {{review}}
+[[File:NationWide Logo.jpeg|right|link=https://www.nwlabs.co.uk/|alt=NationWide Logo|240x240px|In Partnership with NationWide Laboratories|frameless|thumb|]]
 [[Category:Anaemia|2]]
 [[Category:Lymphoreticular and Haematopoietic Diseases - Dog]][[Category:Lymphoreticular and Haematopoietic Diseases - Cat]][[Category:Lymphoreticular and Haematopoietic Diseases - Horse]][[Category:Lymphoreticular and Haematopoietic Diseases - Cattle]][[Category:Donkey]][[Category:Lymphoreticular and Haematopoietic Diseases - Sheep]][[Category:Lymphoreticular and Haematopoietic Diseases - Pig]]

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 == References ==
-‘Text referenced' Nationwide Laboratories: [[NationWide Laboratories]] {{Learning
+Text referenced 'Nationwide Laboratories': [[NationWide Laboratories]] {{Learning
 |flashcards = [[Feline Medicine Q&A 08]] |Vetstream = [https://www.vetstream.com/equis/Content/Disease/dis01203.asp Anemia]
 }}

@@ Line 154: / Line 154: @@
 *Vitamin B12/folate deficiency
-{{Learning
+== References ==
 |flashcards = [[Feline Medicine Q&A 08]] |Vetstream = [https://www.vetstream.com/equis/Content/Disease/dis01203.asp Anemia]
 }}

← Older revision		Revision as of 20:53, 7 March 2022
Line 132:		Line 132:

	'''FIV.''' May be associated with nonregenerative anaemia possibly with concurrent neutropaenia.		'''FIV.''' May be associated with nonregenerative anaemia possibly with concurrent neutropaenia.
		+
		+	References: [[NationWide Laboratories]]

	=== Secondary Anaemia ===		=== Secondary Anaemia ===

@@ Line 102: / Line 102: @@
 The failure to regenerate indicates that there is a failure to produce red blood cells in the bone marrow.  Erythrocytes are produced from stem cells in the bone marrow and they then undergo sequential stages of maturation before and after they are released into the circulation.
-An inadequate degree of reticulocytosis is the essential diagnostic feature. Some reticulocytes may be present but fewer than required for a given degree of anaemia, after sufficient time has elapsed for an erythroid response to have developed. These anaemias are mainly normochromic normocytic. References: [[/en.wikivet.net/NationWide Laboratories|NationWide Laboratories]]
+An inadequate degree of reticulocytosis is the essential diagnostic feature. Some reticulocytes may be present but fewer than required for a given degree of anaemia, after sufficient time has elapsed for an erythroid response to have developed. These anaemias are mainly normochromic normocytic. References: [[NationWide Laboratories]]
 === Primary Anaemia: Failure of the bone marrow stem cells to produce erythroid cells ===
@@ Line 116: / Line 116: @@
 '''Proliferative disorders.''' Can also cause nonregenerative anaemia as neoplastic cells over-run the bone marrow (myelophthisic disease).
 '''[[Immune Mediated Haemolytic Anaemia|Pure red cell aplasia]]'''
-Myelophthisis
+'''Myelophthisis'''
-Myelodysplasia
+=== Iron Deficiency Anaemia ===
-===Failure of erythrocyte maturation===
+=== Failure of erythrocyte maturation ===
 This can occur with:
 *Iron deficiency

@@ Line 90: / Line 90: @@
 *'''Immune-mediated disease''' including [[Immune Mediated Haemolytic Anaemia]] and [[Neonatal Isoerythrolysis]].
 *'''Infectious agents''' including ''[[Babesia|Babesia spp.]]'' in dogs and cattle, ''[[Feline Infectious Anaemia|Mycoplasma haemofelis]]'' in cats, ''[[Leptospira|Leptospira spp.]]'' in various species and ''[[Clostridium haemolyticum]]'' causing redwater fever in cattle.
-*'''Haemotrophic mycoplasmas.''' (Haemoplasmas) are small bacteria that attach to the external erythrocyte membrane. There are multiple species which vary in pathogenicity. In the cat Mycoplasma haemofelis, ‘Candidatus Mycoplasma haemominutum’ and ‘Candidatus Mycoplasma turicensis’ are seen most frequently; a further species, ‘Candidatus Mycoplasma haematoparvum-like’ has been reported in the literature. Mycoplasma haemofelis is the most pathogenic, producing anaemia and clinical signs of disease. ‘Candidatus Mycoplasma haemominutum’ and ‘Candidatus Mycoplasma turicensis’ may cause some changes in red cell parameters but anaemia is only seen in cats with concurrent disease (Retroviral infection), immunocompromised cats or those receiving corticosteroid therapy. In dogs Mycoplasma haemocanis and ‘Candidatus Mycoplasma haematoparvum’ have been identified and may cause haemolytic anaemia in splenectomised or immunocompromised dogs. The method of choice for diagnosis is PCR using appropriate controls on EDTA blood samples. Previously diagnosis was by examination of air-dried blood smears (not EDTA smears) to search for the organisms. Even in the acute phase, parasitaemia is not always present so it may be necessary to take blood and make smears on 5-7 consecutive days. The organisms are very small and must be distinguished from stain precipitate in Romanowsky stained smears, Howell- Jolly bodies and background debris. They may be seen as very small organisms on the periphery of the erythrocyte or form chains and rings. May-Grunwald or acridine orange stains may increasethe sensitivity of blood film examination. References: [[/en.wikivet.net/NationWide Laboratories|NationWide Laboratories]]
+*'''Haemotrophic mycoplasmas.''' (Haemoplasmas) are small bacteria that attach to the external erythrocyte membrane. There are multiple species which vary in pathogenicity. In the cat Mycoplasma haemofelis, ‘Candidatus Mycoplasma haemominutum’ and ‘Candidatus Mycoplasma turicensis’ are seen most frequently; a further species, ‘Candidatus Mycoplasma haematoparvum-like’ has been reported in the literature. Mycoplasma haemofelis is the most pathogenic, producing anaemia and clinical signs of disease. ‘Candidatus Mycoplasma haemominutum’ and ‘Candidatus Mycoplasma turicensis’ may cause some changes in red cell parameters but anaemia is only seen in cats with concurrent disease (Retroviral infection), immunocompromised cats or those receiving corticosteroid therapy. In dogs Mycoplasma haemocanis and ‘Candidatus Mycoplasma haematoparvum’ have been identified and may cause haemolytic anaemia in splenectomised or immunocompromised dogs. The method of choice for diagnosis is PCR using appropriate controls on EDTA blood samples. Previously diagnosis was by examination of air-dried blood smears (not EDTA smears) to search for the organisms. Even in the acute phase, parasitaemia is not always present so it may be necessary to take blood and make smears on 5-7 consecutive days. The organisms are very small and must be distinguished from stain precipitate in Romanowsky stained smears, Howell- Jolly bodies and background debris. They may be seen as very small organisms on the periphery of the erythrocyte or form chains and rings. May-Grunwald or acridine orange stains may increasethe sensitivity of blood film examination. References: [[NationWide Laboratories]]
 *'''Inherited defects of red blood cells enzymes''' including pyruvate kinase (which is occur most commonly in West Highland white terriers) and phosphofructokinase (PFK).
 *'''Pyruvate Kinase deficiency.''' This is an autosomal recessive genetic disease in dogs causing severe persistant extravascular haemolysis. There is usually moderate to severe anaemia (PCV18-25%) with marked reticulocytosis, possibly due to rapid RBC turnover and splenomegaly. PK-deficient RBCs have a shortened life span with inefficient energy production. Affected dogs are young and usually die by the age of 3 years with, in many cases, myelofibrosis and osteosclerosis. PK deficiency is transmitted as an autosomal recessive trait in many breeds of dogs with the highest prevalence in Basenji’s and Beagle’s. PK deficiency has been reported in the DSH, Abyssinian and Somali breeds of cat. References: [[NationWide Laboratories]]
@@ Line 96: / Line 96: @@
 *'''Hypophosphataemia''' which occurs in post-parturient cattle (causing post-parturient haemoglobinuria), with refeeding syndrome and when animals with [[Diabetes Mellitus|diabetes mellitus]] are stabilised with insulin.
 *Exposure to '''toxins''' including rape and kale (which contain SMCO radicals) in cattle, onions and garlic in dogs and paracetamol in cats.
-*'''Microangiopathic anaemia''' which occurs when red blood cells are forced through small meshworks of fibrin as with [[Haemangiosarcoma|haemangiosarcomas]], [[Disseminated Intravascular Coagulation|disseminated intravascular coagulation]] (DIC) or bacterial endocarditis.This is usually a mild, often subclinical anaemia unless there is concurrent haemorrhage from, for example, a tumour. RBCs are damaged as they pass through abnormal vessels or regions of turbulent blood flow, giving rise to schistocytes. These fragmented red cells are phagocytosed by the mononuclear phagocytic system, causing anaemia. Numerous schistocytes in a smear are always significant. References: [[/en.wikivet.net/NationWide Laboratories|NationWide Laboratories]]
+*'''Microangiopathic anaemia''' which occurs when red blood cells are forced through small meshworks of fibrin as with [[Haemangiosarcoma|haemangiosarcomas]], [[Disseminated Intravascular Coagulation|disseminated intravascular coagulation]] (DIC) or bacterial endocarditis.This is usually a mild, often subclinical anaemia unless there is concurrent haemorrhage from, for example, a tumour. RBCs are damaged as they pass through abnormal vessels or regions of turbulent blood flow, giving rise to schistocytes. These fragmented red cells are phagocytosed by the mononuclear phagocytic system, causing anaemia. Numerous schistocytes in a smear are always significant. References: [[NationWide Laboratories]]
 Haemolysis usually results in a more strongly regenerative response than haemorrhage and can be differentiated by plasma protein concentrations; these will fall with haemorrhage, but not with haemolysis.
@@ Line 102: / Line 102: @@
 The failure to regenerate indicates that there is a failure to produce red blood cells in the bone marrow.  Erythrocytes are produced from stem cells in the bone marrow and they then undergo sequential stages of maturation before and after they are released into the circulation.
-===Failure of the bone marrow stem cells to produce erythroid cells===
+An inadequate degree of reticulocytosis is the essential diagnostic feature. Some reticulocytes may be present but fewer than required for a given degree of anaemia, after sufficient time has elapsed for an erythroid response to have developed. These anaemias are mainly normochromic normocytic. References: [[/en.wikivet.net/NationWide Laboratories|NationWide Laboratories]]
 This occurs in the following conditions:
-*'''[[Immune Mediated Haemolytic Anaemia|Pure red cell aplasia]]'''
-*Aplastic anaemia
+'''Bone marrow diseases'''. A method for bone marrow aspiration can be found in the cytology section. Where bone marrow hypoplasia is suspected a core biopsy in formalin should also be taken.
-*Bone marrow suppression
-*Myelophthisis
+'''Bicytopaenia or pancytopaenia.''' Reflects poor marrow production of two or three cell lines. This suggests marrow disease. Because of the long life span of RBCs, anaemia is usually detected later than neutropaenia and thrombocytopaenia.
-*Myelodysplasia
 ===Failure of erythrocyte maturation===