Question

Explain how the tests below differ for acute hemolytic anemia and compensated hemolytic anemia.

PB smear

Hemoglobin

Bone changes

List three laboratory test results from peripheral blood that indicate increased erythropoietic activity in the bone marrow.

Answer 1

Acute hemolytic Anemia :

Anemia isa medical condition in which the capacity of blood to transport oxygen to the tisssues is reduced, either because of too little haemoglobin or because of too few Red blood cells resulting in fatigue and pallor.

Acute hemolytic Anemia occurs due the hemolysis, or abnormal breakdown of the Red blood cells. Hemolysis occurs either in the blood vessels or outside the blood vessels.  

Compensated hemolytic Anemia:   Bone marrow compensates for the reduction of RBC, during hemolysis, It is called Compensated hemolytic Anemia.

Tests:

* PB Smear

Acute hemolytic Anemia: In Peripheral Blood smear test , there will be the presence of Schistocytes or other fragmented RBC ( Mechanical hemolysis) . Spherocytes can be seen in Inherited hemolytic anemias.

Compensated hemolytic Anemia: PBS demonstrate an increased number of reticulocytes ( newly made RBCs ) .

* Haemoglobin

In AHA, haemoglobin : low level of haemoglobin

In Compensated Hemolytic Anemia, Haemoglobin level shows normal or near normal level

* Bone changes :

Acute hemolytic Anemia: Compensatory erythroid hyperplasia due to increased Red blood cell destruction.

CHA : Increased activity of bone marrow , increased number of reticulocytes.

Three laboratory test results from PBS , that indicates increased erythropoietic activity :

Erythropoesis : The production of Red blood cells in the bone marrow is called Erythrpoesis.

i) Reticulocyte count: Reticulocytosis, increased number of newly formed RBCs.

ii) Erythrpoetine test : Increased Erythrpoetine level in the blood.

iii) Increased RBC count.