Normocytic anemia

The patient s white blood cell count may be normal or only slightly elevated. Nonspecific findings include anemia (normocytic, normochromic), thrombocytopenia, an elevated erythrocyte sedimentation rate or C-reactive protein, and altered urinary analysis (proteinuria/microscopic hematuria). 

Patients with IE typically have laboratory abnormalities however, none of these changes is specific for the disease. Anemia (normocytic, normochromic), leukocytosis, and thrombocytopenia may be present. The white blood cell (WBC) count is often normal or only shghtly elevated, sometimes with a mild left shift. Acute bacterial endocarditis, however, may present with an elevated WBC count, consistent with a fulminant infection. The erythrocyte sedimentation rate (ESR) is elevated in 90% to 100% of patients, and the level of C-reactive protein also may be elevated. Often the urinary analysis is abnormal, with proteinuria and microscopic hematuria occurring in approximately 50% of individuals. 

E. Other tests. Nonspecific laboratory findings that support the diagnosis of lead poisoning include anemia (normocytic or microcytic), and basophilic stippling of erythrocytes, a useful but insensitive clue. Acute high-dose exposure may sometimes be associated with transient azotemia (elevated BUN and serum creatinine) and mild to moderate elevation in serum transaminases. Recently ingested lead paint, glazes, chips, or solid lead objects may be visible on abdominal x-rays. CT or MRI of the brain often reveals cerebral edema in patients with lead encephalopathy. Because iron deficiency increases lead absorption, iron status should be evaluated. 

Blood count abnormalities (e.g., normocytic, normochromic anemia, relative lymphocytosis, neutrophilia, eosinophilia)... 

Evaluating the mean corpuscular volume (MCV) is the next step in an anemia work-up. It is classified as microcytic, normocytic, or macrocytic if the MCV is below, within, or above the normal range of 80 to 96 fIVcell, respectively. 

RH is a 7-year-old girl who presents to her pediatrician with a 1 -week history of runny nose and fever. Her mom has noted a lot of bruising on her lower exytremities. Physical examination reveals splenomegaly, multiple petechiae, and pallor. A complete blood count reveals a normochromic, normocytic anemia with a hemoglobin of 6 g/dL (60 g/L,... 

The anemia is usually normochromic and normocytic. Approximately 50% of children present with platelet counts of less than 50 x 1 03/pL (50 x 1 09/L). The WBC count may be normal, decreased, or high. About 20% of patients have WBC counts over 1 00 x 1 03/pL (100 x 109/L), which places them at risk for leukostasis. 

A marked interference with heme synthesis results in a reduction of the hemoglobin concentration in blood. Decreased hemoglobin production, coupled with an increase in erythrocyte destruction, results in a hypochromic, normocytic anemia with associated reticulocytosis. Decreased hemoglobin and anemia have been observed in lead workers and in children with prolonged exposure at higher PbB levels than those noted as threshold levels for inhibition or stimulation of enzyme activities involved in heme synthesis (EPA 1986a). 

Laboratory abnormalities that may be seen include normocytic, normochromic anemia thrombocytosis or thrombocytopenia leukopenia elevated erythrocyte sedimentation rate and C-reactive protein positive... 

Morphologic classifications are based on cell size. Macrocytic cells are larger than normal and are associated with deficiencies of vitamin B12 or folate. Microcytic cells are smaller than normal and are associated with iron deficiency whereas normocytic anemia may be associated with recent blood loss or chronic disease. 

Normocytic anemias Recent blood loss Hemolysis... 

Diagnosis of anemia of chronic disease is usually one of exclusion, with consideration of coexisting iron and folate deficiencies. Serum iron is usually decreased but, unlike iron-deficiency anemia, serum ferritin is normal or increased and TIBC is decreased. The bone marrow reveals an abundance of iron the peripheral smear reveals normocytic anemia. 

Hemolytic anemias tend to be normocytic and normochromic and to have increased levels of reticulocytes, lactic dehydrogenase, and indirect bilirubin. 

The diagnosis (definite or possible endocarditis) according to the 1992 Duke s criteria (see Mandell et al., 2000) is based on blood cultures and echocardiography, the patient s history and findings upon physical examination. This diagnosis should always be considered in patients presenting with fever of unknown origin, especially when they also have a heart murmur and/or normocytic, normochromic anemia. 

Normochromic normocytic anemia is the most common hematological side effect of amphotericin B administration thrombocytopenia and leukopenia are much less common. Infusion of the drug into a peripheral vein usually causes phlebitis or thrombophlebitis. Nausea, vomiting, and anorexia are a persistent problem for some patients. 

L A. Nephrotoxicity is the most common and most serious toxicity associated with amphotericin B administration. This is manifested by azotemia (elevated serum blood urea nitrogen and creatinine), and by renal tubular acidosis, which results in the wasting of potassium and magnesium in the urine (leading to hypokalemia and hypomagnesemia, requiring oral or intravenous replacement therapy). Normochromic normocytic anemia is also seen with long-term amphotericin B administration. Elevation of hver enzymes is not associated with the use of amphotericin B. 

Unlabeled Uses To decrease the risk of colon cancer Contraindications Anemias (aplastic, normocytic, pernicious, refractory)... 

Contraindications All anemias except iron deficiency anemia, including pernicious, aplastic, normocytic, and refractory... 

Leuprolide acetate has been reported to cause normochromic normocytic anemia in patients with benign prostatic hyperplasia (37). The anemia is usually transient, and the hemoglobin returns to baseline 6 months after stopping androgen suppression. There is a single case report of more serious red cell aplasia in a patient receiving gonadorelin, with resolution after treatment was withdrawn (38). 

Amphotericin B is the only polyene antibiotic given parenterally. When the intravenous route is contemplated, amphotericin B is dispersed fresh, as discussed, and infused slowly. Amphotericin B should not be administered rapidly because this causes cardiac toxicity. Heparin (1000 units) is often added to the infusion suspension to avert the risk of thrombophlebitis. Amphotericin B can also precipitate normocytic or normochromic anemia, leukopenia, and thrombocytopenia. 

Normocytic anemias Physical trauma to RBC (artificial valves)... 

SAFETY PROFILE Poison by intraperitoneal route. Questionable carcinogen with experimental tumorigenic data. Human systemic effects irritability, nausea or vomiting, normocytic anemia. 

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