Forwarded from Yassen Ayad
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S5 L2 | Hypoxia and Respiratory failure
Forwarded from Yassen Ayad
S5 L2 Hypoxia and Respiratory failure .pdf
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👉How to differentiate between iron deficiency anemia (IDA) and thalassemia by just looking at CBC only?
👍Especially important to know if you have simple case of thalassemia traits or mild cases of thalassemia receiving iron therapy with no improvement --> still microcytic, still anemic and parents still worried. You will stop giving iron if you recognize the difference.
🟰Both IDA and Thalassemia are microcytic anemia, low hemoglobin, low hematocrit, low MCV.
#RBCs are usually normal or slightly increased in cases of thalassemia.
#RBCs are usually low in cases of iron deficiency anemia.
👉Use Mentzer index which MCV/RBC count in millions
If Mentzer index is >13 it is iron deficiency anemia
If Mentzer index is <13 it is a case of thalassemia.
👨Example. 14-year-old boy with hemoglobin 11.5, RBCs 6.1, MCV 70, RDW is 13.5, platelets 350K, blood film; microcytes 3+.
✅Mentzer index in the case MCV/RBC 70/6.1=11.4 which is < 13 --> this CBC is suggestive of thalassemia trait. Severe cases of thalassemia the Mentzer index is < 9
👍if the CBC is suggestive of thalassemia --> order hemoglobin electrophoresis.
❓If normal result of hemoglobin electrophoresis, most likely alpha thalassemia
✅if abnormal result of hemoglobin electrophoresis this is a case of beta-thalassemia
In addition, RDW is classically high in cases of iron deficiency anemia and platelets are usually elevated in cases of iron deficiency anemia.
👍Especially important to know if you have simple case of thalassemia traits or mild cases of thalassemia receiving iron therapy with no improvement --> still microcytic, still anemic and parents still worried. You will stop giving iron if you recognize the difference.
🟰Both IDA and Thalassemia are microcytic anemia, low hemoglobin, low hematocrit, low MCV.
#RBCs are usually normal or slightly increased in cases of thalassemia.
#RBCs are usually low in cases of iron deficiency anemia.
👉Use Mentzer index which MCV/RBC count in millions
If Mentzer index is >13 it is iron deficiency anemia
If Mentzer index is <13 it is a case of thalassemia.
👨Example. 14-year-old boy with hemoglobin 11.5, RBCs 6.1, MCV 70, RDW is 13.5, platelets 350K, blood film; microcytes 3+.
✅Mentzer index in the case MCV/RBC 70/6.1=11.4 which is < 13 --> this CBC is suggestive of thalassemia trait. Severe cases of thalassemia the Mentzer index is < 9
👍if the CBC is suggestive of thalassemia --> order hemoglobin electrophoresis.
❓If normal result of hemoglobin electrophoresis, most likely alpha thalassemia
✅if abnormal result of hemoglobin electrophoresis this is a case of beta-thalassemia
In addition, RDW is classically high in cases of iron deficiency anemia and platelets are usually elevated in cases of iron deficiency anemia.
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