The Hemopoietic system

The system that forms the cells of blood is known as

hemopoietic systems.
Main components of hemopoietic system are:
(i) blood
(ii) Bone marrow
(iii) Lymph nodes and
(Lymph nodes: Small round or bean shaped masses of lymphatic tissue
surrounded by a capsule of connective tissue. Located in various places
of body. It filter lymphatic fluid and store special cell that can trap cancer
cells or bacteria. )
(iv) thymus (A Lymphoid organ)
Accessory organs of hemopoietic system :
(i) Spleen
(ii)Liver and
(iii) Kidney.
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• Due to defect of RBC

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 Anemia:
• Anemia is defined as the reduced
concentration of hemoglobin in blood. The
commonest cause is blood loss related to
menstruation and child bearing.

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 Types of anemia:

• 1. Hypochromic microcytic anemia - small red cells

with low hemoglobin; caused by iron deficiency.
• 2. Macrocytic anemia - large red cells, few in number.
May be megaloblastic anemia
• 3. Normochromic normocytic anemia - Fewer
normal sized red cells, each with normal hemoglobin
content.
• 4. Mixed pictures :There are some mixed picture also

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Causes of anemia:
• 1. Deficiency of nutrients necessary for hemopoiesis
(Formation of blood) most importantly
- iron, Folic acid and vit B12 , pyridoxin, vit-c, etc

• 2. Depression of bone marrow, caused by

- toxins
- radiation therapy
- diseases of bone marrow of unknown origin
- reduced production of erythropoietin (RBC)

• 3. Excessive destruction of RBC (Hemolytic anemia), this has

many causes including
-hemoglobinopathies (such as sickle cell anemia )
-adverse reaction to drugs and
-inappropriate immune reactions.

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Symptoms and signs of anemia:
The sign symptoms of anemia are as follows:

• Fatigue,
• Faintness,
• Headache,
• Palpitations,
• Angina of efforts,
• Pallor,
• Tachycardia (Rapid heart rate)
• Systolic flow murmur,
• cardiac failure,
• Jaundice etc.
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Hematinics :
• Defination:
Agents that are used in the treatment of anemia
to increase the number of RBC or hemoglobin
content of RBC or both to normal level when
there is deficiency.

• Important hematinics are:

(i) Iron
(ii) Vit. B12
(iii) Folic acid
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 Classification of hematinics (According to diseases)

• A) Drugs used in iron deficiency anemia:

i) Iron preparation: They are two types
a) Oral prep. i) Ferrous sulphate(200-600 mg/day) (20% elemental
iron)
ii) Ferrous gluconate (300-1200 mg/day)(12% elemental iron)

iii) Ferrous fumerate(200-600 mg/day) (33% elemental iron)

iv) Ferrous succinate
v) Ferrous cholinaccetate
vi) Ferrous Carbonate
vii) Ferric ammonium citrate
b) Parenteral preparation:
i) Iron dextran complex (1.5mg/Kg/day)
ii) Iron sorbitol (1.5mg/Kg/day)
iii) Dextroferon

ii) Copper, Cobalt, Pyridoxine, Riboflavin

• B. Drugs used in megaloblastic anaemia:

1. Vit B12 (cyanocobalamine) 2. Folic Acid 3. Vit C 8

Structure of hemoglobin and the basis of oxygen
transfer:

Hemoglobin is made up of four protein chain subunits

globins, each of which contains one haem moiety. Haem
consists of tetrapyrrole porphyring ring containing ferrous
(Fe2+). The iron complexes molecular oxygen by utilizing a
vacant orbital which can be used by a pair of non bonding
electron from oxygen. Here iron picks up or donates
electrons. This reversible binding is the basis of oxygen
transport.

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Site and process of iron
absorption:
• Site of absorption:
The site of iron absorption is the
duodenum and upper jejunum

• Absorption Process: Absorption is a two

stage process involving 1st rapid uptake
across the brush boarder and then transfer
into the plasma from the interior of the
epithelial cells.
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How ascorbic acid stimulate iron
absorption.
• ** Ascorbic acid stimulates iron
absorption partly by forming soluble iron
ascorbate chelates and partly by reducing
ferric iron to more soluble ferrous form.

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Sources of irons: Sources are as follows:

1. > 5 mg / 100 gm of food

(*) Liver
(**) Heart
* Egg Yolk,
beans,
2. = 1.5 mg / 100 gm
- Muscles,
- meats,
- fish,
- fowls,
- green vegetables and
- cereals
3. <1mg/ 100 gm of food
Milk and milk-products,
Non-green vegetables.
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 Daily requirement and loss of iron:
• Daily requirements of iron
Children: 10 - 15 mg
Adult male: 5 - 10 mg
Adult Female: 15 - 18 mg
Pregnancy: 30 - 60 mg
Lactating mother: 30-60 mg
• Iron Loss: Mainly by desquamation from gut & skin
Loss per d ay 0.5 - 1.0 mg
Menstrual Loss: 13.5 mg/ period
Pregnant women = 500 mg / full term pregnancy

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