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Book Details
Abstract
This issue of Medical Clinics, guest edited by Dr. Thomas G. DeLoughery, is devoted to anemia. Articles in this issue include: Anemia: Evaluation and Diagnostic Tests; Anemia of Chronic Disease; B12/Folate Deficiency; Iron Deficiency; Myelodysplasia; Autoimmune Hemolytic Anemia; Congenital Hemolytic Anemia; Sickle Cell Disease; Thrombotic Microangiopathy; Unusual Anemias; and Transfusion Therapy.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
Anemia\r | i | ||
Copyright\r | ii | ||
CME Accreditation Page | iii | ||
PROGRAM OBJECTIVE | iii | ||
TARGET AUDIENCE | iii | ||
LEARNING OBJECTIVES | iii | ||
ACCREDITATION | iii | ||
DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
TO ENROLL | iii | ||
METHOD OF PARTICIPATION | iii | ||
CME INQUIRIES/SPECIAL NEEDS | iv | ||
MEDICAL CLINICS OF NORTH AMERICA\r | v | ||
FORTHCOMING ISSUES | v | ||
May 2017 | v | ||
July 2017 | v | ||
September 2017 | v | ||
RECENT ISSUES | v | ||
January 2017 | v | ||
November 2016 | v | ||
September 2016 | v | ||
Contributors | vii | ||
CONSULTING EDITOR | vii | ||
EDITOR | vii | ||
AUTHORS | vii | ||
Contents | ix | ||
Foreword: This Is Not an Anemic Issue\r | ix | ||
Preface: Anemia: Things Have Changed! | ix | ||
Anemia: Evaluation and Diagnostic Tests | ix | ||
Anemia of Inflammation: A Review\r | ix | ||
Megaloblastic Anemias: Nutritional and Other Causes | ix | ||
Iron Deficiency Anemia | x | ||
Myelodysplastic Syndromes: Updates and Nuances | x | ||
Autoimmune Hemolytic Anemia | x | ||
Congenital Hemolytic Anemia | x | ||
Sickle Cell Disease: A Brief Update | xi | ||
Syndromes of Thrombotic Microangiopathy | xi | ||
Unusual Anemias | xi | ||
Blood Transfusion Therapy | xi | ||
Foreword:\rThis Is Not an Anemic Issue | xiii | ||
Preface:\rAnemia: Things Have Changed! | xv | ||
Anemia | 263 | ||
Key points | 263 | ||
ANEMIA: DEFINITION | 263 | ||
SYMPTOMS AND SIGNS OF ANEMIA | 263 | ||
COMPENSATION FOR ANEMIA | 264 | ||
CLASSIFICATION | 264 | ||
DIAGNOSTIC TESTS | 265 | ||
Complete Blood Count | 266 | ||
Peripheral Blood Smear Assessment | 266 | ||
Reticulocyte Count | 274 | ||
RED CELL INDICES: OLD AND NEW | 275 | ||
BONE MARROW EXAMINATION | 276 | ||
CYTOGENETICS AND MOLECULAR TESTS | 276 | ||
TESTING FOR SPECIFIC CAUSES OF ANEMIA | 277 | ||
Renal Disease | 277 | ||
Anemia of Inflammation | 278 | ||
Endocrine Disease | 279 | ||
Iron Deficiency | 279 | ||
Other Nutritional Deficiencies | 279 | ||
Vitamin B12 deficiency | 279 | ||
Folate deficiency | 279 | ||
Copper | 280 | ||
Thalassemia | 280 | ||
Sickle Cell Disease and Other Hemoglobinopathies | 280 | ||
Hemolysis | 280 | ||
Plasma Cell Myeloma | 281 | ||
Myelodysplastic Syndrome | 281 | ||
A Rational Approach to Anemia | 284 | ||
REFERENCES | 284 | ||
Anemia of Inflammation | 285 | ||
Key points | 285 | ||
EPIDEMIOLOGY | 285 | ||
Anemia in Critical Illness | 285 | ||
Anemia in Obesity | 286 | ||
Anemia in Cancer | 286 | ||
PATHOPHYSIOLOGY | 286 | ||
Regulation of Hepcidin | 287 | ||
Iron Sequestration | 289 | ||
Changes in Erythrocyte Membrane | 289 | ||
NEW EXPERIMENTAL MODELS | 289 | ||
EXPERIMENTAL TREATMENTS | 292 | ||
REFERENCES | 293 | ||
Megaloblastic Anemias | 297 | ||
Key points | 297 | ||
MEGALOBLASTIC ANEMIAS: NUTRITIONAL AND OTHER CAUSES | 297 | ||
Introduction | 297 | ||
Pathogenesis of Megaloblastic Anemia | 298 | ||
Clinical Picture | 299 | ||
Laboratory Features | 299 | ||
CONDITIONS THAT MAY CONFUSE OR OBSCURE THE PICTURE OF MEGALOBLASTIC ANEMIA | 301 | ||
Coexistent Microcytic Anemia | 301 | ||
Acute Leukemia and Myelodysplasia | 301 | ||
Attenuated Megaloblastic Anemia | 301 | ||
Acute Megaloblastic Anemia | 301 | ||
CAUSES OF VITAMIN B12 DEFICIENCY | 302 | ||
Impaired Absorption | 302 | ||
Helicobacter pylori Infection | 302 | ||
Gastrectomy Syndromes | 302 | ||
Hyperchlorhydria | 302 | ||
Diseases of the Small Intestine | 303 | ||
Inherited Disorders of Vitamin B12 Absorption | 303 | ||
Miscellaneous Causes | 303 | ||
Inherited Disorders of B12 Metabolism | 303 | ||
Homocystinuria | 304 | ||
Methylmalonic Aciduria and Homocystinuria | 304 | ||
CLINICAL FEATURES OF B12 DEFICIENCY | 304 | ||
Neurologic Abnormalities | 304 | ||
Concealed B12 Deficiency | 304 | ||
MANAGEMENT AND PROGNOSIS | 305 | ||
Injected Vitamin B12 | 305 | ||
High-dose Oral Treatment | 305 | ||
Special Circumstances | 305 | ||
CAUSES OF FOLATE DEFICIENCY | 305 | ||
Cause and Pathogenesis | 305 | ||
Dietary Deficiency | 306 | ||
Impaired Absorption | 306 | ||
Other Intestinal Defects | 306 | ||
Increased Requirements | 306 | ||
Increase in Cell Turnover | 307 | ||
CLINICAL FEATURES OF FOLATE DEFICIENCY | 307 | ||
LABORATORY FEATURES OF FOLATE DEFICIENCY | 307 | ||
OTHER EFFECTS OF FOLATE DEFICIENCY | 307 | ||
Neural Tube Closure | 307 | ||
INBORN ERRORS OF FOLATE METABOLISM | 307 | ||
Hereditary Folate Malabsorption | 307 | ||
Dihydrofolate Reductase Deficiency | 308 | ||
Methionine Synthase (MTR) Deficiency | 308 | ||
Methylene Tetrahydrofolate Reductase Deficiency | 308 | ||
MANAGEMENT AND PROGNOSIS | 308 | ||
DRUG-INDUCED MEGALOBLASTIC ANEMIA | 308 | ||
OTHER RARE CAUSES OF MEGALOBLASTIC ANEMIA | 309 | ||
Congenital Dyserythropoietic Anemia | 309 | ||
Refractory Megaloblastic Anemia | 309 | ||
Acute Erythroid Leukemia | 309 | ||
Thiamine-responsive Megaloblastic Anemia | 309 | ||
REFERENCES | 309 | ||
Iron Deficiency Anemia | 319 | ||
Key points | 319 | ||
INTRODUCTION | 319 | ||
IRON METABOLISM | 319 | ||
EPIDEMIOLOGY AND ETIOLOGIES | 320 | ||
SYMPTOMS | 322 | ||
DIAGNOSIS | 323 | ||
TREATMENT | 324 | ||
INTRAVENOUS IRON | 326 | ||
DETERMINING THE ETIOLOGY OF IRON DEFICIENCY | 327 | ||
SUMMARY | 328 | ||
REFERENCES | 328 | ||
Myelodysplastic Syndromes | 333 | ||
Key points | 333 | ||
INTRODUCTION | 333 | ||
CLINICAL VIGNETTE 1: DIAGNOSTIC CONSIDERATIONS IN MYELODYSPLASTIC SYNDROME | 334 | ||
ASSESSMENT OF CLINICAL VIGNETTE 1 | 334 | ||
CLINICAL VIGNETTE 2: EVALUATING PATIENTS WHO FAIL HYPOMETHYLATING AGENTS | 337 | ||
ASSESSMENT OF CLINICAL VIGNETTE 2 | 337 | ||
CLINICAL VIGNETTE 3: RISK-ADAPTED TREATMENT AND ALLOGENEIC BLOOD AND MARROW TRANSPLANT | 341 | ||
ASSESSMENT OF CLINICAL VIGNETTE 3 | 342 | ||
SUMMARY AND FUTURE CONSIDERATIONS | 345 | ||
REFERENCES | 345 | ||
Autoimmune Hemolytic Anemia | 351 | ||
Key points | 351 | ||
INTRODUCTION | 351 | ||
CLINICAL PRESENTATION AND DIAGNOSIS | 352 | ||
TREATMENT | 355 | ||
Corticosteroids | 355 | ||
Splenectomy | 355 | ||
Immunosuppressive Drugs | 356 | ||
Anti-CD20 Therapy (Rituximab) | 356 | ||
SUMMARY | 357 | ||
REFERENCES | 357 | ||
Congenital Hemolytic Anemia | 361 | ||
Key points | 361 | ||
INTRODUCTION | 361 | ||
CLINICAL PRESENTATION | 362 | ||
Baseline | 362 | ||
Hemolytic Event | 362 | ||
Aplastic Event | 363 | ||
Complications | 363 | ||
LABORATORY FEATURES | 363 | ||
DIFFERENTIAL DIAGNOSIS | 364 | ||
MEMBRANOPATHIES | 364 | ||
Hereditary Spherocytosis | 364 | ||
Pathophysiology | 364 | ||
Epidemiology | 366 | ||
Diagnosis | 366 | ||
Disease severity | 366 | ||
Clinical presentation | 367 | ||
Treatment | 367 | ||
Hereditary Elliptocytosis | 367 | ||
ENZYMOPATHIES | 367 | ||
Glucose-6-Phosphate Dehydrogenase Deficiency | 368 | ||
Pathophysiology | 368 | ||
Epidemiology | 368 | ||
Disease severity | 368 | ||
Diagnosis | 368 | ||
Clinical presentation | 369 | ||
Treatment | 369 | ||
Pyruvate Kinase Deficiency | 369 | ||
Pathophysiology | 369 | ||
Epidemiology | 369 | ||
Diagnosis | 370 | ||
Clinical presentation | 370 | ||
Treatment | 370 | ||
HEMOGLOBINOPATHIES | 370 | ||
THALASSEMIA | 370 | ||
Alpha-Thalassemia | 371 | ||
Sickle Cell Disease | 375 | ||
Key points | 375 | ||
INTRODUCTION | 375 | ||
EPIDEMIOLOGY | 376 | ||
PATHOPHYSIOLOGY | 376 | ||
Molecular Mechanisms | 376 | ||
Cellular Mechanisms | 377 | ||
DISEASE SEVERITY AND PROGNOSIS | 378 | ||
MANAGEMENT | 382 | ||
Infection Prevention | 382 | ||
Red Blood Cell Transfusions | 382 | ||
Iron Chelation | 384 | ||
Hydroxyurea | 385 | ||
Hematopoietic Stem Cell Transplantation | 386 | ||
Treatments in Development | 386 | ||
ACKNOWLEDGMENTS | 387 | ||
REFERENCES | 387 | ||
Syndromes of Thrombotic Microangiopathy | 395 | ||
Key points | 395 | ||
INTRODUCTION | 395 | ||
Classical Thrombotic Thrombocytopenic Purpura | 396 | ||
Clinical presentation | 396 | ||
Neurologic | 396 | ||
Hematologic | 396 | ||
Renal | 397 | ||
Gastrointestinal | 397 | ||
Pulmonary | 397 | ||
Cardiac | 397 | ||
Pathogenesis | 397 | ||
CONGENITAL THROMBOTIC THROMBOCYTOPENIC PURPURA | 398 | ||
HEMOLYTIC UREMIC SYNDROME | 399 | ||
Typical Hemolytic Uremic Syndrome | 399 | ||
Atypical Hemolytic Uremic Syndrome | 399 | ||
Complement Factor H Point Mutations | 400 | ||
Autoantibodies to Factor H | 400 | ||
Membrane Cofactor Protein | 400 | ||
Complement Factor B and C3 Convertase | 400 | ||
Factor I | 400 | ||
METABOLISM-MEDIATED MICROANGIOPATHY | 401 | ||
COAGULATION-MEDIATED MICROANGIOPATHY | 401 | ||
DRUG-RELATED THROMBOTIC MICROANGIOPATHY | 402 | ||
STEM CELL TRANSPLANT–RELATED THROMBOTIC MICROANGIOPATHY | 402 | ||
PREGNANCY RELATED THROMBOTIC SYNDROMES | 403 | ||
UPCOMING THERAPIES | 404 | ||
Recombinant ADAMTS13 | 404 | ||
Caplacizumab | 405 | ||
Bortezomib | 405 | ||
SUMMARY | 405 | ||
REFERENCES | 405 | ||
Unusual Anemias | 417 | ||
Key points | 417 | ||
THALASSEMIA | 417 | ||
COPPER DEFICIENCY | 420 | ||
PAROXYSMAL NOCTURNAL HEMOGLOBINURIA | 420 | ||
APLASTIC ANEMIA | 421 | ||
PURE RED CELL APLASIA | 424 | ||
ACQUIRED HEMOLYTIC ANEMIAS | 426 | ||
SUMMARY | 427 | ||
REFERENCES | 427 | ||
Blood Transfusion Therapy | 431 | ||
Key points | 431 | ||
INTRODUCTION | 431 | ||
RISKS OF BLOOD TRANSFUSION | 432 | ||
INDICATIONS FOR RED BLOOD CELL TRANSFUSION THERAPY | 433 | ||
Pediatric Patients | 433 | ||
Adult Patients | 435 | ||
Clinical Practice Guidelines | 438 | ||
Improving Blood Utilization | 440 | ||
SUMMARY | 442 | ||
REFERENCES | 442 | ||
Index | 449 |