Microcytic Anemias
Continuing Education Credits
Objectives
- Identify the classification schemes for anemia to include different forms of microcytic anemia.
- Identify etiology and physiology of the microcytic anemias presented.
- Recognize classic morphological changes found in the different forms of microcytic anemia presented.
- Describe key laboratory assays and their purpose in differentiating causes of microcytic anemia.
- State expected results of different forms of microcytic anemia for identified laboratory tests.
Course Outline
- Review of Erythrocyte Stages and Morphology of Normal Maturation
- Erythrocyte Stages of Maturation Review: Terminology
- Erythrocyte Stages of Maturation: Normal Morphology
- Normal Erythrocyte Morphology
- Which of the following stages of erythrocyte maturation are normally found in the peripheral blood?
- Anemia Review
- General Characteristics
- General Characteristics
- Classifications
- Classification of Anemia
- Morphologic Classification of Anemia
- Calculations of Red Blood Cell Indices
- The classification of anemia may include which of the following categories?
- A patient has a RBC count of 4.7 X 1012/L, hemoglobin of 110 g/L (11.0 g/dL), and hematocrit of 35.0%. What are the calculated RBC indices and how would this be classified?
- Microcytic Anemia: Introduction and Definitions
- Introduction
- Etiology: Heme Metabolism
- Etiology: Iron Metabolism
- Heme development begins with the action of ALA synthase on what molecules to form aminolevulinic acid (ALA)?
- A lack of one or more enzymes in the heme pathway will result in which of the following?
- The molecule transferrin is actually apoferritin that is bound to:
- Microcytic Anemia: Classifications and Diagnosis
- Classifications of Microcytic Anemia
- Four Types of Microcytic Anemia
- Laboratory Diagnosis of Microcytic Anemia
- Laboratory Diagnosis of Microcytic Anemia
- Laboratory Diagnosis: Hematology
- Laboratory Diagnosis: Chemistry
- Which of the following would be the most helpful in the diagnosis of a case of sideroblastic anemia based on hematology findings alone?
- A 44-year-old patient complaining of chronic fatigue has a CBC done for an initial evaluation. The results show a decreased H&H, MCV, and MCHC. Follow up iron studies showed a decreased serum iron, increased TIBC, and decreased ferritin. Which of the following causes of the patient's fatigue is most likely?
- Which of the following laboratory tests would be the most useful in differentiating sideroblastic anemia from anemia of chronic inflammation?
- Diagnosis of Iron Deficiency Anemia (IDA)
- IDA: Causes and Symptoms
- IDA: Stages
- IDA: Laboratory Diagnosis
- What is the most common cause of iron deficiency anemia worldwide?
- Extreme fatigue, weakness, glossitis, a craving for ice, and spooning nails are symptoms that are generally associated with which of the following forms of microcytic anemia?
- A patient has decreased hemoglobin, serum iron, and ferritin. What stage of iron deficiency anemia does this most likely represent?
- Diagnosis of Sideroblastic Anemia (SA)
- Causes and Symptoms of Inherited SA
- Causes and Symptoms of Non-Clonal Acquired SA
- Causes and Symptoms of Clonal SA
- SA: Laboratory Diagnosis
- SA: Laboratory Diagnosis, continued
- SA: Laboratory Diagnosis, continued
- SA: Laboratory Diagnosis of Inherited Porphyrias
- There are several different forms of porphyrias based on the etiology and type of enzymes that have been impaired. However, three major forms are associated with hematologic complications resulting in sideroblastic anemia. Which of the following enzymes are associated with hematologic complications?
- Up to one-third of patients with chronic alcohol consumption have been associated with sideroblastic anemia. What is the effect of alcohol that creates sideroblastic anemia?
- Which of the following genes has not been associated with clonal sideroblastic anemia?
- The presence of these cells in the peripheral blood smear (top image on the right) or bone marrow (bottom image on the right) would rule out which of the following?
- Diagnosis of Anemia of Chronic Inflammation (ACI)
- ACI: Causes and Symptoms
- ACI: Laboratory Diagnosis
- ACI: Algorithm
- Which of the following most likely represents a diagnosis of anemia of chronic inflammation?
- What molecule does hepcidin degrade that then inhibits the transport of iron from the intestine into the blood?
- Summary
- In Summary
- References
- References
Additional Information
Level of Instruction: Beginner
Intended Audience: Medical laboratory scientists and technicians and other health care personnel who have an interest in this subject matter. This course is also appropriate for medical laboratory science students and pathology residents.
Author Information: Andrea Gordon, M.Ed., MLS(ASCP)SH holds a master's degree in Community Health Education from Plymouth State University and a bachelor's degree in Medical Technology from the University of New Hampshire. She holds certification as a Medical Laboratory Scientist from the American Society of Clinical Pathology along with a Specialist in Hematology. Most of her career has been in the education of medical laboratory technicians and scientists after thirteen years in the clinical setting. She has over 25 years of experience as a Program Director for various laboratory science programs. She has approximately 5 years of experience as an administrator in higher education as a VP and Director of Education. Additionally, she has over 15 years of experience as a volunteer for NAACLS.
Reviewer Information: Margaret Reinhart, MS, MLS(ASCP) is a Senior Lecturer emerita in Biological Sciences at the University of the Sciences in Philadelphia, PA where she taught hematology, clinical immunology, parasitology, and other related courses, as well as directed the MLS program for over 30 years. She is currently an adjunct instructor in Hematology at Pennsylvania Hospital, Philadelphia, PA. She holds a Masters Degree in Biology and in Health Care Administration.
Course Description: The role of the laboratory in diagnosing microcytic anemia cannot be overstated. The most common cause of anemia worldwide is iron deficiency which can easily be identified through the work of the hematology and clinical chemistry laboratories. However, there are other causes of microcytic anemia that must be differentiated in order to ensure the proper treatment. This course will provide a brief review of normal erythrocyte maturation, morphology, and function, as well as the classification of anemia before looking more closely at the classification, etiology, and specific diagnostic tests used to properly identify the cause of microcytic anemia.