Hemolytic anemia
СAUSES.
- Congenital inferiority of red blood cells - Exposure to anti-erythrocyte antibodies - Poisoning with hemolytic poisons
Types of hemolysis: intravascular, extravascular.
SYMPTOMS. Leading syndromes: - anemic,
- hemolytic jaundice.
- Complaints: chills, fever, jaundice, nosebleeds, hematuria, hemorrhagic rash, weakness, dyspepsia, shortness of breath.
- Splenomegaly - Hepatomegaly
Blood.
Red blood cells and HB. Lowered.
Poikilocytosis, anisocytosis.
Normochromic red blood cells - normal color index (MCH).
reticulocytosis.
Positive Coombs test (intravascular hemolysis)
pro-erythronormoblasts 40-60% Urine: a lot of urobilin
Kal: a lot of stercobilin
6. Hemorrhagic syndrome
REASONS: various disorders of hemostasis and vascular permeability of hereditary or acquired origin, vasculitis.
SYMPTOMS:
bruises, bruising
petechial rash on the skin and mucous membranes
hemoptysis
bleeding from the nose, gums, stomach, intestines, urinary and genital tracts, etc.
positive tests of the tourniquet, pinch, Konchalovsky-Rumpel-Leed, etc.
The clinical manifestations of hemorrhagic diathesis are characterized by the five most common types of bleeding (Barkagan Z.S., 1975,1980):
Hematoma type
Petechial-spotted (bruise) type
Mixed (bruise-hematoma) type
Vasculitis-purple type
Angiomatous type
108
Pic 7.2 Vasculitis purple type
pic 7.3
Petechial spotted (bruise) type
(Hemorrhagic vasculitis).
7. Inflammatory syndrome
REASONS: the development of infectious complications, especially against the background of
hemoblastoses
SYMPTOMS:
fever
sore throats
abscesses
glossitis, stomatitis
picture of sepsis
any foci of infection
corresponding changes in laboratory inflammatory activity (ESR, CRP, seromucoid, etc.)
Hyperplastic syndrome CAUSES. Leukemic tissue infiltration. Symptoms
A painless enlargement of the lymph nodes, liver and spleen, tonsils (they increase significantly, become loose, can make breathing difficult).
A marked increase in the lymph nodes in the mediastinum is possible, which can lead to compression of the superior vena cava and impaired outflow of blood into the right atrium (superior vena cava syndrome with the main clinical manifestations - shortness of breath, cyanosis, swelling of the neck, swelling of the cervical veins).
Gingival hyperplasia and the development of severe ulcerative necrotic stomatitis are also characteristic, with ulcerative necrotic lesions of the tonsils, oral mucosa that extends to the pharynx and esophagus.
Ossalgia - soreness when bruising the bones due to the development of subperiosteal leukemic infiltrates.
Leukemia infiltrates appear on the skin in the form of leukemids - common reddish-bluish papule-shaped plaques.
Severe manifestations of hyperplastic syndrome are also severe painful testicular infiltration and damage to the nervous system - neuroleukemia.