Transcription
Greetings. Let's continue our talk about hematology. Today's topic is low immune hemolytic anemia, but just basically an introduction coming up. This is médicos is perfection Alice. So all of hematology and oncology are in this slide.
So far, we have been talking about anemia for a long time; we are still here, but I promise we are coming. I'll talk about all of these things, including leukemia and lymphoma, later. So please consider subscribing.
As you know, the multipotent stem cells in the bone marrow have myeloid and lymphoid stem cells. Myeloid will give us the red blood cell through many steps, from blast to site. So what's anemia from a laboratory standpoint? Anemia is low hemoglobin, low hematocrit, and low red blood cell count. Usually, low red blood cell count is not that important; low hemoglobin and low hematocrit—that's anemia. You don't need to have a low red blood cell count on the lab results; just both of them, you have anemia.
Next step is: is the anemia microcytic, normocytic, or macrocytic? We do the MCV—mean corpuscular volume. Less than 80, this is microcytic; 80 to 100, normocytic; more than 100, macrocytic. We have finished talking about this and this; we are still here. Normocytic anemia: cells are normal size, from 80 to 100. If you have an anemia, this anemia has an MCV of 80 to 100; this is normocytic anemia. And normocytic anemia can be acute blood loss, due to underproduction, or due to over destruction or hemolysis. We have talked about this, and we have talked about all of these: any of Crohn's disease or deficiency, aplastic anemia, chronic renal failure, malignancy. We are done, and we are still here in the hemolytic anemia. Again, these will have low reticulocyte count. Hemolysis will have a reticulocyte count, provided that the bone marrow is good enough to respond and to produce a lot of cells, including baby red blood cells, which are reticulocytes. And it can be due to an intrinsic or intracorpuscular defect, or extrinsic or extracorpuscular defect.
Here we have hemoglobin defect, such as sickle cell; membrane defects, such as spherocytosis; enzyme defect, pyruvate kinase deficiency, glucose-6-phosphate dehydrogenase deficiency; or extrinsic—outside of the red blood cell—such as a valve, a Oryx enosis, complement called a glutton disease because it activates the complements through IgM, autoantibody antibodies, such as warm autoimmune hemolytic anemias. Here we have IgG; cold agglutinin can be both complement or antibodies; it doesn't matter. Now, immune hemolytic anemias are classified into three subtypes: autoimmune is by far the most common; you have the warm and the cold subtypes; drug-induced hemolytic anemia; and we have talked about that. And now let's talk about low immune hemolytic anemia. Basically, it's a fight between the self and the non-self. So here is the big picture, but first, what does "alloimmune" mean? Immune is easy—immune related immunity—but what about allo? You have a difference between allo and auto. Okay, we're talking about hematology/oncology; this is huge. Auto just means self; allo means non-self; it's not you. If you know about transfusion, such as organ transfusion, it can be autologous, which means I'm transfusing organs or part of my body from my own, like from me and to me, or can be allogeneic, which means I'm getting a part of a body from another person. So auto means self; allo means non-self; autologous transplant; allogeneic transplant. So alloimmune means you have an immune problem due to a non-self, something from outside of you. So we have hemolytic disease of the newborn; can have different subtypes: Rh disease, ABO incompatibility, and others, such as anti-Kell, rhesus, C, Risa, C kids, and Duffy and all of this crazy stuff. Okay. And next video, we'll talk about hemolytic disease of the newborn, and I'll see you then. Please don't forget to subscribe; new videos are coming. And like me on Facebook; I'm posting a lot of questions and answers there. Thank you so much.