NHS临床指南 Diagnosing Iron Deficiency Anaemia in Primary Care.pptVIP

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2018-02-11 发布于江苏
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NHS临床指南 Diagnosing Iron Deficiency Anaemia in Primary Care.ppt

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NHS临床指南 Diagnosing Iron Deficiency Anaemia in Primary Care

Diagnosing Iron Deficiency Anaemia in Primary Care Dr Peter Johnson Consultant Haematologist Western General Hospital 10.01.16 Referral to Gastroenterology Reason for referral: Anaemia Main referral text: I would be grateful for your assessment of this 72 year old retired minister who presented feeling tired and reported sleeping an extra 2 hours over the Christmas period, feeling run down and no longer swimming. Routine bloods show haemoglobin 106 down from 120 in June last year when he was seen in AE following a faint. In February 2015 it was 136. He denies any other symptoms. No nosebleeds or blood loss from anywhere. He has a reasonable diet. The only other change over the last year has been in his renal function and he has dipstick haematuria and proteinuria. I think he warrants upper and lower GI endoscopies. Thank you for seeing him. Hb 106 (135-180) MCV 95 (78-98) WBC 4.5 (4-11) Plts 354 (150-400) eGFR 40 ESR 39 (1-10) B12 246 (180-2000) Folate 11.0 (2.8-20) Ferritin 563 (20-300) 10.01.16 Referral to Gastroenterology Reason for referral: Anaemia Main referral text: I would be grateful for your assessment of this 72 year old retired minister who presented feeling tired and reported sleeping an extra 2 hours over the Christmas period, feeling run down and no longer swimming. Routine bloods show haemoglobin 106 down from 120 in June last year when he was seen in AE following a faint. In February 2015 it was 136. He denies any other symptoms. No nosebleeds or blood loss from anywhere. He has a reasonable diet. The only other change over the last year has been in his renal function and he has dipstick haematuria and proteinuria. I think he warrants upper and lower GI endoscopies. Thank you for seeing him. Common causes of anaemia Iron deficiency Megaloblastic anaemia B12, folate Anaemia of chronic disorders Haemolytic anaemia AIHA Haemoglobinopathies eg. thalassaemia Bone marrow hypoplasia Chemotherapy, radiotherapy, haem maligs, non-haem maligs