macrocytic anemia

normocytic anemia

microcytic hypochromic anemia

Reduced RBC production

RBC destroys too much

blood loss

dysplastic anemia

proliferative anemia

Fatigue, sleepiness, and weakness are the most common and earliest symptoms of anemia. Some patients may develop low-grade fever. Pale skin and mucous membranes are the main signs of anemia. Iron deficiency anemia causes flat nails, anti-nails, thick and brittle nail striae, and renal anemia and megaloblastic anemia cause edema and paleness.

Palpitations and shortness of breath are most common after activity. Dyspnea occurs in more severe anemia, with rapid heart rate, strong heartbeat, and increased pulse pressure. Some patients may have anemic heart disease

Headache, dizziness, dizziness, tinnitus, difficulty concentrating and drowsiness, etc. Lack of sleep, weakness, and fatigue are symptoms of muscle tissue hypoxia.

Loss of appetite, bloating, nausea, etc. are common symptoms. Loss of appetite and anorexia are early manifestations of megaloblastic anemia. Atrophy of the lingual papilla is seen in nutritional anemia;

Increased nocturia, decreased urine specific gravity, changes in sexual desire, and menstrual disorders are also common in female patients.

The skin is dry, the hair is dry, and wounds heal slowly. Pale fundus and retinal hemorrhage are occasionally seen.

Ask about medical history

Physical examination

Auxiliary inspection

Types of anemia

Accompanying symptoms and signs

Normal iron content for adult men is 50mg/Kg and for women is 35mg/Kg

Increased requirements for women of childbearing age, infants, children and adolescents during growth and development

Food composition is unreasonable

Drugs or stomach or duodenal diseases

Children and adolescents have developmental delays, reduced physical strength, low IQ, excitability, inattention, irritability, irritability or apathy, pica and dysphagia (Plummer-Vinson syndrome).

In addition to pale skin and mucous membranes, hair is dry and easy to fall off and break, nails are flat, dull, and easily broken. Some patients have spoon-shaped nails (antionychia) or mildly enlarged spleens.

Dizziness, headache, pale complexion, fatigue, easy fatigue, palpitations, shortness of breath after activity, vertigo and tinnitus, etc.

1. Microcytic hypochromic anemia: male hemoglobin HGB＜120g/L, female HGB＜110g/L, MCV＜80fl, MCH＜27pg, MCHC＜0.32, RBC morphology is hypochromic.

2. Have clear causes and clinical manifestations of iron deficiency

3. Ferritin SF＜14μg/L (for diagnosis of non-simple iron deficiency, the SF standard can be raised to <60μg/L)

4. Serum iron SI<8.95μmol/L, total iron binding capacity TIBC>64.44μmol/L

5. Transferrin saturation TS＜0.15

6. Bone marrow iron staining shows that the small bone marrow granules that can be stained with iron disappear and sideroblasts are less than 15%.

7. FEP>0.9μmol/L (whole blood), or blood ZPP>0.96μmol/L (whole blood), or ZPP>3μg/gHGB

8. Serum sTfR (serum soluble TfR) concentration >26.5nmol/L (2.25mg/L)

9. Iron treatment is limited

Oral iron supplements

iron injection

Valid criteria

Cure criteria

Replenish iron stores

Diseases resulting from abnormal quality of hematopoietic stem cells (HSCs), such as PNH

Autoimmune mediated AA, such as systemic lupus erythematosus, Hashimoto's thyroiditis

Cytopenia of undetermined significance

Hematopoietic cell tumors, such as hairy cell leukemia, MM

Tumors from other systems infiltrate bone marrow

myelofibrosis

severe nutritional anemia

Chemical substances, drugs, radiation damage, viral infections, etc.

HSC toxic damage

HSC own defects

Heavy AA (SAA)

Non-heavy duty AA (NSAA)

bone marrow cytology examination

bone marrow biopsy

HGB＜100g/L

PLT count＜50*10 9/L (children＜100*10 9/L)

ANC＜1.5*10 9/L

The acid hemolysis test (Ham) test, sugar water test and urine hemosiderin test (Rom test) were all positive. Neutrophil alkaline phosphatase activity is normal or reduced, and clinically, recurrent hemoglobinuria (soy sauce-colored urine), jaundice, and splenomegaly are common.

The blood picture shows a decrease in one or two items, which does not necessarily mean pancytopenia. Erythroid megaloblastic changes, unbalanced nuclear and cytoplasmic development, obviously active bone marrow hyperplasia, and pathological hematopoiesis in the three lineage cells are the obvious characteristics of this disease.

Safeguard

blood transfusion

control infection

control bleeding

iron removal therapy

NSAA

SAA