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Anemia (Normochromic and Normocytic)
Published in Charles Theisler, Adjuvant Medical Care, 2023
In normocytic and normochromic anemia, blood cells are of normal size and have adequate hemoglobin concentration, but are present in insufficient quantities to transport normal amounts of oxygen to the tissues. Normocytic anemia has many causes, the most common being anemia of chronic diseases (e.g., kidney disease, cancer, RA, and thyroiditis), but also includes blood loss or hemolysis, bone marrow suppression, man-made heart valves, or drug therapy. Normocytic anemia also commonly develops due to aging and is more likely to affect women over the age of 85.1 Normocytic anemia symptoms are not very prominent as the condition will usually tend to build up gradually over a period of time. However, when it has fully progressed, the condition will present with typical symptoms of pallor, tiredness, and weakness, etc.1
Unexplained Fever In Hematologic Disorders Section 1. Benign Hematologic Disorders
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Isolated normocytic anemia may be seen in any chronic infectious inflammatory and malignant disorder. Usually the anemia is not severe, but in chronic renal failure, hemoglobin down to 7 g per dl may be quite commonly observed. Typically, the serum iron is low and transferrin levels are also below normal. Thus, in contrast to iron deficiency anemias, iron saturation is often within normal limits, levels of ferritin are also normal or somewhat elevated.
Anemia: Approach to Diagnosis
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
The etiologies of normocytic anemia include acute blood loss, hemolytic anemia, anemia of chronic disease, anemia of chronic renal disease, hematologic malignancy, myelophthisic anemia, aplastic anemia, and the anemia associated with endocrinopathies. The most common cause of normocytic anemia is acute hemorrhagic anemia, the second most common cause of anemia in the United States (22–25% of cases).
Hb Santa Juana (β 108(G10) Asn > Ser): a low oxygen affinity hemoglobin variant in a family of Bosnian background
Published in Hematology, 2023
N. P. Wildenberg, C. Rossi, A. E. Kulozik, J. B. Kunz
Decreased oxygen affinity, characterized by a rightward shift in the oxygen binding curve, may be clinically associated with cyanosis, hypoxemia and normocytic anemia. The latter is thought to be a compensatory mechanism resulting from increased oxygen delivery to tissues and consecutive low erythropoietin levels. Because the lower oxygen affinity allows the loaded oxygen of the arterial blood to be exploited very effectively, hemoglobin variants with reduced oxygen affinity typically do not impair physical performance [1]. The most apparent symptom cyanosis, either episodically or constantly, appears to be directly linked to oxygen affinity. Variants with an p50 (O2) that is higher than twice the normal, such as Hb Kansas, Beth Israel, St. Mandé or Bassett, are associated with cyanosis (see Supplemental Table, [7–19]). In contrast, variants with a p50 (O2) below 50 mmHg, such as Hb Chico, Sunshine Seth, St. George or Santa Juana, do not or only under certain conditions present with cyanosis but may be detected by low pulse oximetry readings. Mild normocytic anemia has been observed in many of these variants but is typically asymptomatic. The complications and symptoms that had been attributed to Hb Santa Juana in the family we report here, most importantly miscarriage, gastroesophageal reflux disease and severe fatigue, are likely not causally related to the hemoglobin variant.
Clinical features of anemia in membranous nephropathy patients: a Chinese cohort study
Published in Renal Failure, 2023
Zhe Li, Weibo Le, Haitao Zhang, Dacheng Chen, Wencui Chen, Shuhua Zhu, Ke Zuo
The diagnostic criteria for anemia were defined as hemoglobin (Hb) <130 g/L in males and Hb <120 g/L in nonpregnant females [10]. The criteria for mild anemia were 110 g/L ≤ Hb < lower limit of the normal reference value, those for moderate anemia were 80 g/L ≤ Hb <110 g/L, and those for severe anemia were Hb <80 g/L [11]. Mean corpuscular volume (MCV) <80 fL, mean corpuscular hemoglobin (MCH) level <27 pg and mean corpuscular hemoglobin concentration (MCHC) <320 g/L were required for microcytic hypochromic anemia. The criteria for normocytic anemia were 80 fL ≤ MCV ≤100 fL, 27 pg ≤ MCH ≤34 pg, and 320 g/L ≤ MCHC ≤360 g/L [12]. The criteria for complete correction of anemia were Hb ≥130 g/L in males and 120 g/L in nonpregnant females after anemia treatment. The criteria for standard anemia treatment were 110 g/L ≤ follow-up Hb < lower limit of the normal reference value. The criterion for nonstandard anemia treatment was follow-up Hb <110 g/L [10]. The criteria for complete remission (CR) of MN were 24-h urine protein content <0.3 g, serum albumin (Alb) >35 g/L and stable serum creatinine (sCr) for more than 6 months. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to estimate the glomerular filtration rate (eGFR) [13]. Renal endpoint events were defined as eGFR reduction >30% within 2 years of follow-up or regular dialysis [14].
Accidental discovery of metastasized basal cell carcinoma
Published in Acta Chirurgica Belgica, 2022
Hanne Verberght, Thomas Schok, Siebe Wouda, Frits Aarts
The patient was admitted to the internal medicine department and had a consultation with general surgery. A normocytic anemia caused by chronic illness and type 2 diabetes was newly discovered upon admission. Histopathological investigation of the biopsy specimens from the lesion confirmed the diagnosis of solid growing basal cell carcinoma. An additional CT scan (thorax/abdomen/pelvis) showed a pathological fracture of the sacrum, a lung lesion in the right lower lobe (20 mm), and two liver lesions (8 and 21 mm). Bone biopsies confirmed the suspicion of metastatic basal cell carcinoma (Figure 2). Solid growing BCC with liver, lung, and bone metastases was diagnosed. The histology images confirmed the diagnosis of BCC as BerEp4 and cytokeratin 7 immunohistology were positive. In this case, p40 was also positive, which may indicate the development of squamous cell carcinoma (SCC). However, in SCC, BerEp4 and cytokeratin 7 immunohistology are negative.