Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (285 page)

Hereditary Stomatocytosis

Hemolytic Extrinsic Red Blood Cell Defects

Autoimmune Hemolytic Anemias (AIHAS)

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Paroxysmal Cold Hemoglobinuria (PCH)

Hemolytic Disease of the Newborn

Mechanical Hemolysis

Evans Syndrome

Erythrocytosis

White Blood Cell Disorders

Leukocytosis and Leukopenias

Neutropenia

Agranulocytosis

Lymphocytosis

Lymphocytopenia

Monocytosis

Eosinophilia

Persistent Eosinopenia

Basophilia

Leukemoid Reactions

Acute Leukemias

B Lymphoblastic Leukemia/ Lymphoma (B-ALL)

Acute Myeloid Leukemia (AML)

T Lymphoblastic Leukemia/ Lymphoma (T-ALL)

Chronic Leukemias

Chronic Myelogenous Leukemia

Chronic Eosinophilic Leukemia (CEL) and Hypereosinophilic (HES) Syndrome

Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL)

Prolymphocytic (PLL) Leukemia of B- and T-Cell Subtype

Hairy Cell Leukemia

T-Cell Large Granular Lymphocytic Leukemia (T-LGL)

Chronic Neutrophilic Leukemia

Multilineage Diseases

Myeloproliferative Neoplasms (MPNS)

Chronic Myelogenous Leukemia (CML)

Polycythemia Vera (PV)

Essential Thrombocythemia (ET)

Primary Myelofibrosis (PMF)

Myelodysplastic Syndrome (MDS)

Chronic Myelomonocytic Leukemia (CMML)

Splenomegaly

Lymphomas

Non-Hodgkin Lymphomas

Burkitt Lymphoma (BL)

Cutaneous T-Cell Lymphomas: Mycosis Fungoides (MF) and Sézary SYNDROME (SS)

Diffuse Large B-Cell Lymphoma (DLBCL)

Follicular Lymphoma (FL)

Mantle Cell Lymphoma (MCL)

Marginal Zone Lymphoma (MZL)

Posttransplant Lymphoproliferative Disorder (PTLD)

Lymphoplasmacytic Lymphoma (LPL)/Waldenström Macroglobulinemia (WM)

Hodgkin Lymphoma (HL)

Monoclonal Gammopathies

Plasma Cell Myeloma

Monoclonal Gammopathy of Undetermined Significance (MGUS)

Plasma Cell Leukemia (PCL)

Monoclonal Light and Heavy Chain Deposition Diseases

Plasmacytoma

Immunoglobulin Light Chain Amyloidosis (ILCA)

Cryoglobulinemia

Cryofibrinogenemia

Disorders of Hemostasis and Thrombosis

Disorders of Platelets: Thrombocytopenias

Immune Thrombocytopenic Purpura (ITP)

Drug-Induced Thrombocytopenia, Immune

Heparin-Induced Thrombocytopenia (HIT)

Neonatal Thrombocytopenia

Pseudo (Spurious) Thrombocytopenia

Disorders of Platelet Function: Inherited and Acquired

Inherited Thrombocytopathies

Acquired Thrombocytopathies

Disorders Due to Coagulation Factor Deficiencies: Congenital Clotting Defects

Hemophilia

von Willebrand Disease (VWD)

Factor XII (F XII) Deficiency

Factor XI (F XI) Deficiency

Factor XIII (F XIII) Deficiency

Acquired Hemorrhagic Disorders of Multifactorial Etiology

Disseminated Intravascular Coagulation (DIC)

Hereditary Hemorrhagic Telangiectasia (HHT)

Hemostatic Failure in Cardiopulmonary Bypass Surgery

The Coagulopathy of Liver Disease

Anticoagulants, Circulating

Thrombotic Disorders

Thrombophilia

Antiphospholipid Antibody Syndrome (APS)

Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome (TTP/HUS)

Miscellaneous Disorders

Iron Overload Disorders (IOD) and Hereditary Hemochromatosis (HH)

This Chapter covers blood diseases encompassing pathology of the formed elements of blood (red cells, white cells, and platelets), monoclonal plasmatic dyscrasias, hemorrhagic and thrombotic diseases, and lastly metabolic disorders that have a major impact on hematologic parameters.

   
RED BLOOD CELL DISORDERS

ANEMIAS

   Definition

Anemia is a reduction in Hb leading to decrease in oxygen supply to peripheral tissues. Normal hemoglobin (Hb) range is established by population studies, but range should be adjusted for different age groups, especially for children, and levels are lower in women and in African Americans. There is some debate whether people of older ages have
physiologically
lower Hg levels. Most likely lower values reflect underlying pathology. Hb values are more accurate than hematocrit (Hct) values, because Hb is measured directly by automated analyzers, whereas the Hct is a calculated value.

   Diagnosis

   There are many ways to classify anemias, but the differential diagnosis of anemia can be narrowed by using the RBC size, as reflected in the MCV and the reticulocyte count. See Figure
9-1
.

   In addition, insight into mechanism and etiology complements the differential diagnosis.

   Onset of anemia has a great impact on symptoms and diagnosis.