Principles of Hematology

Pamelah Kihembo
MPHN
Principles of hematology
• Hematologic diseases are a heterogeneous group of diseases that can
have multiple clinical and laboratory manifestations that mimic non
hematologic diseases.
• For that reason, a detailed clinical history and physical exam are
essential. Frequently, laboratory tests will be necessary to confirm the
clinical diagnosis.
• The goal of this topic is to help students understand the basic
mechanisms of biochemical nutrition status assessment using blood
samples
Approaches to haematology
• Hematologic disorders can be approached by identifying the primary
hematologic component that is affected: RBCs, WBCs, platelets, or the
coagulation system. The major abnormalities in haematology are
quantitative in nature, with either excessive or deficient production of
one of the hematopoietic constituents (e.g., leukemias, anemias).
• Qualitative abnormalities also can be inherited (e.g., sickle cell
disease) or acquired
• In haematology, blood samples are used to evaluate patients for
possible hematologic disorders, and in this case, nutritional disorders
• Before sending a patient to a haematologist/lab technician, you must
be conversant with the following:
• History
• The medical/nutrition history is the first step in hematology diagnostic
assessment. With simple questions we can evaluate causes of a
suspected nutritional deficiency or a nutritional disorder.
• The history must include detailed notes on social status, medical
records, diet history and any other information related to the
patients’ problem.
Physical Exam
• The physical exam is also an important part of the diagnostic process.
Along with the history, it can suggest a diagnosis, guide lab testing,
and aid in the differential diagnosis. A full clinical assessment must be
done on the patient.
 Nutritional disorders of blood
eficiency anemia
pallor
mucous membranes
nea
ness
n nails
ing
min K deficiency
ice
liver functionality
ood cell destruction
billirubinemia
Common Diagnostic Tests in hematology
1. Anemia
The hemoglobin test is used to measure the amount of red blood cells in the body. The protein
carries oxygen from the lungs to the cells. A blood sample is collected by pricking the finger or
drawing blood from the vein on your arm

a) Hemoglobin g/dl**
•Children 6 months to 59 months - 11.0
•Children 5–11 years - 11.5
•Children 12–14 years -12.0
Non-pregnant women (above 15 years of age -12.0
•Pregnant women - 11.0
•Men (above 15 years of age) - 13.0
** Below these values, anemia will be present in the population
b) Hematocrit - A haematocrit test is part of a complete blood count
(CBC).
• Male: 41% to 50%
• Female: 36% to 44%
• For babies, normal results are:
• New born: 45% to 61%
• Infant: 32% to 42%
Hematocrit
2. Spontaneous bleeding
Platelet count - Platelets are very important, as they prevent bleeding by forming clots and sealing blood
vessels if they become damaged. A platelet count is usually part of a complete blood count (CBC).

Normal platelet count range: Between 150,000 and 400,000 platelets per microliter.
Low platelet count (thrombocytopenia): Less than 150,000 platelets per microliter. It can be due to:
• Bone marrow damage. Cancer treatments, such as chemotherapy or radiation therapy.
• Certain cancers, such as leukemia or lymphoma.
• Certain medications.
• Enlarged spleen.
• Heavy drinking (alcohol).
• Hemolytic uremic syndrome (a disease that destroys platelets).
• Immune thrombocytopenia (spots of bleeding or bruises under the skin due to low platelets).
• Severe bleeding after an injury.
• Thrombotic thrombocytopenic purpura (blood clots in small blood vessels throughout the body).
• Viral or bacterial infections.
• Symptoms of too few platelets include:
• Blood in your vomit, urine or bowel movements.
• Bruising easily.
• Excessive bleeding from small cuts, gums or nosebleeds.
• Menorrhagia (heavy menstrual bleeding).
• Muscle or joint pain.
• Severe headaches.
• Weakness or dizziness.
High platelet count (thrombocytosis): More than 450,000 platelets per microliter. It can be as a result
of
• Gene mutation
• Recurrent Infections.
• Problems with the genes that control platelet production.
• Some cancers.
Symptoms and complications of too many platelets include:
• Bruising easily.
• Chest pain
• Thrombosis (blood clotting when not required).
• Excessive bleeding from small cuts, gums or nosebleeds.
• Leg swelling.
• Shortness of breath
• Stroke
• Tingling or burning in your fingertips, hands and feet.
• Weakness, dizziness or fatigue