650370
Description
Mind Map by v.djabatey, updated more than 1 year ago
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Created by v.djabatey
about 10 years ago
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Anaemia in the newborn
- reduced RBC prodn
- 2 main but rare causes
- both cause red cell aplasia
- low Hb
- RBCs look normal
- diagnostic clues
- low reticulocyte count
- normal bilirubin
- low reticulocyte count
- low Hb
- congenital infection w/ parvovirus B19
- congenital red cell aplasia (Diamond-Blackfan anaemia)
- both cause red cell aplasia
- 2 main but rare causes
- increased RBC destruction (haemolytic anaemia)
- due
to
- antibody
destroying
RBCs (i.e.
extrinsic cause)
- immune causes
- haemolytic disease of the newborn
- aka immune
haemolytic
anaemia of
newborn
- caused by
antibodies vs
blood group
antigens
- most important antibodies
- anti-D
- anti-A
- anti-B
- anti-Kell
- anti-D
- mum is always
-ve to the
relevant antigen
& baby always
+ve
- mum makes
antibodies vs
baby's blood
group
- mum's antibodies
cross placenta into
baby's circulation
- -> fetal or
neonatal
haemolytic
anaemia
- diag using
Coombs test
(direct
anti-globulin test)
- only +ve in antibody-mediated anaemias
- only +ve in antibody-mediated anaemias
- diag using
Coombs test
(direct
anti-globulin test)
- -> fetal or
neonatal
haemolytic
anaemia
- mum's antibodies
cross placenta into
baby's circulation
- mum makes
antibodies vs
baby's blood
group
- most important antibodies
- aka immune
haemolytic
anaemia of
newborn
- haemolytic disease of the newborn
- immune causes
- intrinsic
abnormality of
surface or
intracellular
contents of
RBCs
- red cell mb disorders
- hereditary spherocytosis
- hereditary spherocytosis
- red cell
enzyme
disorders
- glucose-6-phosphate
dehydrogenase
deficiency
- glucose-6-phosphate
dehydrogenase
deficiency
- abnormal haemoglobins
- alpha-thal major
- other
haemoglobinopathies
rarely present w/ sx in
neontal period
- but detected on Guthrie test
- but detected on Guthrie test
- alpha-thal major
- red cell mb disorders
- antibody
destroying
RBCs (i.e.
extrinsic cause)
- diagnostic clues
- raised reticulocyte count
- due to increased
RBC prodn to
compensate for
anaemia
- due to increased
RBC prodn to
compensate for
anaemia
- raised unconjugated bilirubin
- due to increased
RBC destruction w/
the bile pigment
released into
plasma
- due to increased
RBC destruction w/
the bile pigment
released into
plasma
- raised reticulocyte count
- due
to
- blood loss
- feto-maternal haemorrhage
- occult bleeding into mum
- occult bleeding into mum
- twin-to-twin transfusion
- bleeding
from one
twin into the
other one
- bleeding
from one
twin into the
other one
- blood loss around the time of delivery
- e.g. placental abruption
- e.g. placental abruption
- diagnostic clues
- severe anaemia
- raised reticulocyte count
- normal bilirubin
- severe anaemia
- feto-maternal haemorrhage
- anaemia of prematurity
- inadequate
erythropoietin
productn
- reduced RBC
lifespan
- frequent
blood
sampling
whilst in
hospital
- Fe & folic
acid
deficiency
(after 2-3
months)
- inadequate
erythropoietin
productn
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