a kerythrocytes

takes barely a week. This time can be

shortened to a few days if erythropoiesis is
stimulated, for example, by an increase in cell
loss (hemolysis or bleeding). As the average
life-span of RBCs in peripheral blood is more
than 100 days, a brief disorder of cell formation
is not detectable, but increased cell loss
quickly results in anemia. (With neutrophil
leukocytes, whose differentiation time is
roughly as long, the reverse is the case, because
their life-span in peripheral blood is
only about 10 hours: neutropenia occurs if
there is an acute disorder of cell formation,
but not after cell loss.)
With a survival time of ca.107 sec and a total
RBC count of ca. 1.6 × 1013 in blood, the rate
of formation is 1.6 million erythrocytes per
second. If necessary, this production rate increases
up to tenfold without causing bone
marrow exhaustion. Life-long hemolytic anemia,
for example, can thus largely be compensated.
Disorders of erythrocyte metabolism, be it
abnormal erythropoiesis in its various steps
( A), a shortened life-span, or chronic blood
loss, can be differentiated by means of a number
of diagnostic parameters:
! Stem cells obtained by bone marrow puncture
can be stimulated to proliferate and differentiate
by erythropoietin in a cell culture. Colonies
of more or less differentiated, hemoglobin-
containing cells (E) are formed in this way
(burst-forming units [BFU-E] or colony-forming
units [CFU-E]). Their number is decreased if
the anemia is caused by abnormal cell formation;
it is increased if the cells are lost in a late
stage of differentiation (erythroblast, erythrocyte)
(A1).
! Erythroblasts can be morphologically identified
and quantified in a stained bonemarrow
sample. They decrease in number in aplasia
and in defects of stem cell differentiation;
they increase if erythropoiesis is stimulated,
for example, by increased hemolysis (A2).
 elainan intelektual dan atau fungsi neurologik
! The efficiency of the entire erythropoiesis can

yang menetap, ini menunjukan betapa

pentingnya peran hormon tiroid dalam perkembangan otak saat masa
tersebut. Setelah usia 3
tahun , sebagian besar perkembangan otak yang tergantung hormon
tiroid sudah lengkap,
hipotiroidisme pada saat ini mengakibatkan pertumbuhan lambat dan
keterlambatan maserasi
tulang, biasanya tidak menetap dan tidak berpengaruh pada
perkembangan kognitif dan
neurologik, sehingga perlu dilakukan skrinning untuk deteksi dan terapi

dini.

been more regular and less heavy

Gastritis erosevia, ulkus peptikum dan kolitis uremika.

a. Kulit
o Kulit berwarna pucat akibat anemia dan kekuning – kuningan akibat
penimbunan urochrome.

little more frequently, but it does not hurt when she passes urine and her urine does not
appear cloudy or smell different from usual. Over the p Her periods normally come every 21–35
days and she has not had one this time for 40 days,
although she has had some spotting for the past few days. She feels a little nauseated and
her breasts are tender as if her period is about to arrive. She has been periods have

has a 2-day history of lower abdominal pain. The pain is low down in the right side of her
abdomen and is constant and sharp, worse when she passes a bowel motion or sits down.
going to the toilet
ast day or two she has been feeling a
little faint at times. She does not have a vaginal discharge and has not felt feverish. She has a
long history of adenomyosis and pelvic inflammatory disease that has required many general
practice and hospital visits and investigations. Recently, she has been much improved – her
o Gatal – gatal dengan ekskoriasi akibat toksin uremik dan pengendapan
kalsium di pori – pori kulit.
o Echymosis akibat gangguan hematologik.
 o Urea fost : akibat kristalisasi urea yang ada pada keringat.
o Bekas – bekas garukan karena gatal.

diperantai oleh stimulasi

sintesis dan kerja hormon pertumbuhan dan IGF. Disfungsi tiroid pada
masa bayi dan anak
dapat berakibat kelainan metabolik yang ditemukan pada dewasa,
berpengaruh pada
pertumbuhan dan perkembangan, karena maturasi jaringan dan organ
atau Jaringan spesifik
yang merupakan pengatur perkembangan bergantung pada efek hormon
tiroid, sehingga
konsekuensi klinik disfungsi tiroid bergantung pada usia mulai timbulnya
pada masa bayi dan
anak. Apabila hipotiroidisme pada janin atau bayi baru lahir tidak diobati,
menyebabkan