The haemoglobin molecule Human haemoglobin is formed from two pairs of globin chains each with a haem group attached. Seven different globin chains are synthesised in normal subjects; two, ε and ζ, are characteristic of the embryo and contribute to…
Assessing the likelihood of acquired haemolytic anaemia Haemolytic anaemia may be suspected from either clinical or laboratory abnormalities. Suggestive clinical features include anaemia, jaundice and splenomegaly. Other relevant clinical features that should be sought are a history of autoimmune disease,…
The various initial steps to be taken in the investigation of a patient suspected of having a haemolytic anaemia are outlined in Chapter 11 and the changes in red cell morphology that may be found in haemolytic anaemias are illustrated…
Red cells are typically removed from the circulation at the end of their lifespan of about 120 days. A shortened lifespan due to premature destruction may lead to haemolytic anaemia when bone marrow activity cannot compensate for the erythrocyte loss.…
Acknowledgements Many thanks indeed to Dr Malcolm Hamilton and Mrs. Sheena Blackmore, authors of this chapter in editions 10 and 11 of this series. The descriptions of metabolic pathways for cobalamin, folate and homocysteine were assisted by Hematology Basic Principles…
Iron metabolism The iron content of the body and its distribution among the various proteins are summarised in Table 9-1 . Most of the iron is present in the oxygen-carrying protein of the red blood cell, haemoglobin, the synthesis and…
Acknowledgements We would like to thank Dr Tom Vulliamy and other previous authors for their past contribution in the preparation of this chapter and we refer to past editions for a full extent of their work. Our understanding of the…
Biopsy of the bone marrow is an indispensable adjunct to the study of diseases of the blood and may be the only way in which a correct diagnosis can be made. Marrow can be obtained by needle aspiration, percutaneous trephine…
Tests for the acute-phase response Inflammatory response to tissue injury (i.e. the acute-phase response) includes alteration in serum protein concentration, especially increases in fibrinogen, haptoglobin, caeruloplasmin, immunoglobulins (Ig) and C-reactive protein (CRP), and a decrease in albumin. The changes occur…
Examination of a fixed and stained blood film is an essential part of a haematological investigation, and it cannot be emphasised too strongly that, to obtain maximum information from the examination, the films must be well spread, well stained and…