Terapigrupp anemi. Mikael Olsson, hematologi HSV Gottskär 21/3-2017
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1 Terapigrupp anemi Mikael Olsson, hematologi HSV Gottskär 21/3-2017
2 Diagram and photomicrographs of the erythrocytic series. Blood and Hemopoiesis Gartner, Leslie P., PhD, Textbook of Histology, 10, e2 Copyright 2017 Copyright 2017 by Elsevier, Inc. All rights reserved.
3 Anemiutredning Hb, TPK och LPK med differentialräkning Retikulocyter MCV
4 Anemiutredning
5 The role of hepcidin in iron metabolism. Goodnough L T et al. Blood 2010;116:
6 Järnstatus S-fe Transferrin Järnmättnad Ferritin CRP! (Transferrinreceptor, Ret-HE, Benmärg)
7 Järnbehandling
8 Järn - kostnader
9 Intravenöst järn Pris på Recept Avtalade priser på rekvisition Preparat Styrka Dos pris per dos (kr) kr/mg pris per dos (kr) kr/mg Monofer 100 mg/ml 1000 mg , ,39 Monofer 100 mg/ml 500 mg , ,39 Venofer 20 mg/ml 100 mg 163 1, ,46
10 Kostnad intravenöst järn - Receptförskrivning Arbetsplats Kostnad (kr) Förpackningar (st) Region Halland - arbetsplats Totalt 1,7 miljoner kr 782 Mödrahälsovård/Ungdomsmott Primärvård Specialistvård Kostnad intravenöst järn - Rekvisition Arbetsplats Kostnad (kr) Förpackningar (st) Region Halland Totalt 1,4 miljoner kr 920 HALLANDS SJUKHUS HALMSTAD HALLANDS SJUKHUS VARBERG HALLANDS SJUKHUS KUNGSBACKA
11 Iv järn Hypersensitivity reactions to intravenous iron: guidance for risk minimization and management, D Rampton et al, Haematologica 2014;99(11)
12 Maps of the distribution of the inherited disorders of hemoglobin. ( A ) Structural hemoglobin variants. ( B ) Thalassemias. ( Adapted from Refs.7 9,61 ) The Present and Future Global Burden of the Inherited Disorders of Hemoglobin Piel, Frédéric B., PhD, Hematology/Oncology Clinics of North America, Volume 30, Issue 2, Copyright 2015 Elsevier Inc.
13 Clinical classification and genotype phenotype correlation of α- (left) and β-thalassemia (right). In this figure, the genotype phenotype correlation of β-thalassemia is focused on the β-globin gene itself. The effect of genetic modifiers has been excluded. Update in the genetics of thalassemia: What clinicians need to know Shang, Xuan, PhD, Best Practice & Research: Clinical Obstetrics & Gynaecology, Volume 39, 3-15 Copyright 2016
14 Thalassemi MCV<78 Fraktionerat hemoglobin
15 Peripheral blood film in megaloblastic anaemia. There is a macrocytosis and the neutrophils are hypersegmented. Megaloblastic anaemia Howard, Martin R, MBChB MD FRCP FRCPath, Haematology: An Illustrated Colour Text, 13, Copyright Elsevier Ltd
16 Vitaminstatus S-folat (B-folat) B12 Homocystein, MMA
17 Vitaminbehandling
18 Renal anemi GFR <30 (<50) Till njursviktspatienter rekommenderas S-Ferritin>200 μg/l transferrinmättnad >25 % retikulocythemoglobin >30 pg.
19 Dysplastic cell morphologic abnormalities commonly observed in the peripheral blood or marrow of patients with myelodysplastic syndrome (MDS). A, Multinucleated erythroid precursor. B, Megaloblastoid maturation of erythroid precursors with open nuclear chromatin. C, Ring sideroblast (pathologic erythroid precursor). D, Hypogranular neutrophils. E, Pseudo-Pelger-Huët anomaly (hypolobated neutrophil). F, Abnormal nuclear lobation in a megakaryocyte a Pawn Ball cell with three separated nuclei/nuclear lobes. A, B, D, and F are Wright-Giemsa stained marrow aspirate; C is Perls' Prussian blue reaction of marrow aspirate; E is Wright-Giemsa stained peripheral blood. (Figures courtesy Elizabeth A. Morgan, MD, PhD, Brigham & Women's Hospital.) Myelodysplastic Syndromes Steensma, David P., Goldman-Cecil Medicine, 182, e3 Copyright 2016 Copyright 2016, 2012, 2008, 2004, 2000, 1996, 1991, 1988, 1982, 1979, 1975, 1971, 1963, 1959, 1955 by Saunders, an imprint of Elsevier Inc.
20 Acute myeloid leukemia. Bone marrow aspirate smear showing monoblasts with round nuclei, prominent nucleoli, and finely granular cytoplasm. (Wright-Giemsa stain.) Tumors of the Hematopoietic System Kutok, Jeffery L., Diagnostic Histopathology of Tumors, Chapter 22, Copyright 2013 Copyright 2013 by Saunders, an imprint of Elsevier Inc.
21 Bone marrow aspirate smear from a patient with B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma showing sheets of small mature-appearing neoplastic lymphoid cells that are nearly indistiguishable from normal small B lymphocytes. (Wright-Giemsa stain.) Tumors of the Hematopoietic System Kutok, Jeffery L., Diagnostic Histopathology of Tumors, Chapter 22, Copyright 2013 Copyright 2013 by Saunders, an imprint of Elsevier Inc.
22 Mature-type myeloma. Bone marrow aspirate smear from a 58-year-old woman with extensive marrow replacement with plasma cell myeloma. The plasma cells have cytologic features approximating those of mature plasma cells (Wright-Giemsa stain). (Courtesy Dr. Patrick C. J. Ward, Department of Pathology, University of Minnesota, Duluth, Minn.) Plasma Cell Neoplasms McKenna, Robert W., Hematopathology, Chapter 26, e9 Copyright 2017 Copyright 2017 by Elsevier, Inc. All rights reserved.
23 Använd SVF! Kriterier på App: Cancervård
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Participants Identification No. % Evaluation. Mitotic figure Educational Erythrocyte precursor, abnormal/
Cell Identification BMD-09 Participants Identification No. % Evaluation Mitotic figure 233 96.7 Educational Erythrocyte precursor, abnormal/ 4 1.7 Educational dysplastic nuclear features Erythrocyte precursor
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