Anemia, Pt. 2 Flashcards
What 2 lab findings point toward non-regenerative anemia?
- no polychromasia
- no or inadequate reticulocytes
- <80,000/µL (canine)
- <60,000/µL (feline)
What are 3 causes of non-regenerative anemia?
- impaired or decreased RBC production by the bone marrow
- defective erythrocyte production
- too early for regeneration to happen when there is blood loss or destruction
What 6 things cause reduced erythropoiesis to induce non-regenerative anemia?
- chronic disease causing inflammation (neoplasia)
- toxins - Bracken fern, estrogen, radiation
- lack of EPO from chronic renal disease, hypoadrenocorticism, or hypothyroidism
- immune-mediate pure cell aplasia
- infections - FeLV, Anaplasma, Parvovirus, Feline Panleukopenia
- myelophthisis - myelofibrosis, myeloproliferative disorders, osteopetrosis, osteosclerosis
What 3 things cause defective erythropoiesis to induce non-regenerative anemia?
- abnormal maturation congenital in Herefords, English Springer Spaniels, and Poodles; erythremic myelosis, myelodysplastic syndrome
- disorders of heme synthesis - chlorampenicol toxicity, copper deficiency, iron deficiency, lead poisoning, molybdenum poisoning, vitamin B6 deficiency
- disorders of nucleic acid synthesis - vitamin B12 deficiency, malabsorption, folic acid deficiency
What are 4 causes of non-regenerative anemia?
- anemia of inflammatory disease/anemia of chronic disease/anemia of inflammation
- chronic renal disease
- bone marrow hypoplasia/aplasia
- nutritional deficiencies
What is the most common cause of non-regenerative anemia in domestic species?
anemia of inflammatory disease
(anemia of chronic disease, anemia of inflammation)
What are the 3 most common lab findings with anemia of inflammatory disease?
- mild to moderate anemia
- normocytic, normochromic
- low serum iron - sequestered in macrophages responding to cause inflammation
What are common infectious and non-infectious causes of anemia of inflammatory disease?
INFECTIOUS - chronic infections with Babesia, fungi, viruses, or protozoa
NON-INFECTIOUS - autoimmune disease, toxins, neoplasia
What is multifactorial process of the pathophysiology of anemia of inflammatory disease?
- IL-6 induces hepcidin synthesis, which inhibits iron transport from duodenal enterocytes and macrophages and decreases iron absorption and sequestered iron in macrophages (ferritin stores)
- decreased erythropoiesis caused by inappropriately low secretio of EPO, decreased response of bone marrow to EPO due to TNFα, low iron
What are 4 possible mechanisms of chronic renal disease causing non-regenerative anemia?
- decreased EPO production
- suppressive effects of uremic toxins on bone marrow
- blood loss chronically from GI, skin, and other sites due to qualitative platelet dysfunction due to uremic toxins
- shortened RBC survival due to mild hemolysis
What are the 2 common lab findings with chronic renal disease causing anemia?
- normocytic, normochromic
- moderate to severe non-regenerative anemia
What are 4 causes of bone marrow erythroid hypoplasia inducing non-regenerative anemia?
- FeLV-induced erythroid hypoplasia
- pure red cell aplasia
- endocrine disorders
- immune-mediated
How does FeLV cause non-regenerative anemia?
damages or kills erythroid precursors selectively, causing erythroid cells to transform or to become neoplastic
- erythrocytes are produced, but with defects
- circulation of abnormal nRBCs
What is the most common lab finding in FeLV-induced erythroid hypoplasia?
macrocytic normochromic anemia
- asynchronous maturation of nucleus compared to cytoplasm
How does pure red cell aplasia cause non-regenerative anemia? What is thought to be the mechanism? What are the 2 lab findings?
marked hypoplasia or aplasia in the bone marrow decreasing erythroid cells
possible EPO Abs
- normocytic normochromic anemia
- spherocytes