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Essentials of Haematology
Shirish M Kawthalkar
SECTION I: PHYSIOLOGY OF BLOOD
CHAPTER 1:
Overview of Physiology of Blood
NORMAL HAEMATOPOIESIS
Hierarchy of Haematopoiesis
Haematopoietic Growth Factors (HGFs)
GM-CSF
G-CSF
Erythropoietin
The Haematopoietic Microenvironment
RED BLOOD CELLS
Stages of Erythropoiesis
Structure and Function of Erythrocytes
Haemoglobin
Red Cell Enzymes
Red Cell Membrane
WHITE BLOOD CELLS
Neutrophils
Stages of Granulopoiesis
Eosinophils
Basophils
Monocytes
Lymphocytes
B Lymphocytes
T lymphocytes
Natural Killer (NK) Cells
White Cell Antigens
The HLA System
Neutrophil-specific Antigens
IMMUNE SYSTEM
Antibodies
Structure of Immunoglobulins
Classes of Immunoglobulins
Complement
Classical Pathway
Alternate Pathway
Regulation of Complement Activity
Various Effects of Complement Activation
THROMBOCYTOPOIESIS
NORMAL HAEMOSTASIS
Vascular Wall
Platelets
Ultrastructure of Platelets
Platelet Membrane Glycoproteins
Platelet Antigens
Role of Platelets in Haemostasis
Plasma Proteins in Haemostasis
Coagulation System
Mechanism of Blood Coagulation
Fibrinolytic System
Natural Inhibitors of Coagulation
SECTION II: DISORDERS OF RED BLOOD CELLS (ANAEMIAS)
CHAPTER 2:
Approach to Diagnosis of Anaemias
APPROACH TO DIAGNOSIS
Establishing the Presence and Severity of Anaemia
Determination of Haemoglobin Concentration
Determination of Packed Cell Volume or PCV (Haematocrit)
Determining the Cause of Anaemia
Clinical Evaluation
Laboratory Evaluation
Classification of Anaemias into Three Morphological Types
Evaluation of Macrocytic Anaemias
Evaluation of Microcytic Hypochromic Anaemia
Evaluation of Normocytic Normochromic Anaemia
CHAPTER 3:
Anaemias due to Impaired Red Cell Production
NORMAL IRON METABOLISM
Iron Requirements
Dietary Sources of Iron
Absorption of Iron
Transport of Iron
Incorporation of Iron in Erythroid Precursors
Storage of iron
CAUSES OF IRON DEFICIENCY ANAEMIA
CLINICAL FEATURES
General Clinical Features of Anaemia
Clinical Features Related to Iron Deficiency
Clinical Features due to Underlying Cause of Iron Deficiency
LABORATORY FEATURES
Peripheral Blood Examination
Red Cell Indices
Bone Marrow Examination
Serum Ferritin
S. Iron, TIBC, and Percent Transferrin Saturation
Soluble Transferrin Receptor (TfR) Assay
Free Erythrocyte Protoporphyrin (FEP)
Investigations to Define Underlying Cause of Iron Deficiency
DIFFERENTIAL DIAGNOSIS
Thalassaemia Minor
Anaemia of Chronic Disease
Sideroblastic Anaemia
TREATMENT OF IRON DEFICIENCY ANAEMIA
NORMAL VITAMIN B12 METABOLISM
Sources of Vitamin B12
Absorption of Vitamin B12
Transport of Vitamin B12
Storage Sites
Functions of Vitamin B12
Synthesis of Methionine from Homocysteine
Conversion of Methyl Malonyl CoA to Succinyl CoA
NORMAL FOLATE METABOLISM
GENERAL MORPHOLOGICAL FEATURES OF MEGALOBLASTIC ANAEMIA
Peripheral Blood
Red Cells
White Cells
Platelets
Bone Marrow
CAUSES OF MEGALOBLASTIC ANAEMIA
Deficiency of Folate
Causes of Folate Deficiency
Clinical Features
Laboratory Features
Treatment of Folate Deficiency
Deficiency of Vitamin B12
Causes of vitamin B12 Deficiency
Clinical Features
Laboratory Features
Treatment of Vitamin B12 Deficiency
Miscellaneous Causes of Megaloblastic Anaemia
Drugs
Haematologic Disorders
Acute Megaloblastic Anaemia
Congenital Defects of Metabolism
ACQUIRED APLASTIC ANAEMIA
Causes
Pathogenesis
Clinical Features
Laboratory Features
Tests to Establish the Diagnosis of Aplastic Anaemia
Tests to Determine Cause of Aplastic Anaemia
Differential Diagnosis
Treatment
Haematopoietic Stem Cell Transplantation (HSCT)
Immunosuppressive Therapy
Androgens
Supportive Measures
Prognosis
CONSTITUTIONAL APLASTIC ANAEMIA
Fanconi's Anaemia
Other Constitutional Aplastic Anaemias
PURE RED CELL APLASIA
Constitutional Pure Red Cell Aplasia (Diamond-Blackfan syndrome)
Acquired Pure Red Cell Aplasia
PATHOGENESIS
Decreased Red Cell Survival
Decreased Red Cell Production
Impairment of Iron Metabolism
CLINICAL FEATURES
LABORATORY FEATURES
DIFFERENTIAL DIAGNOSIS
TREATMENT
SIDEROBLASTS
TYPES AND CAUSES
PATHOGENESIS
Hereditary Sideroblastic Anaemia
Primary Acquired Sideroblastic Anaemia
Secondary Acquired Sideroblastic Anaemia
PATHOGENESIS
Loss of Endocrine Function of Kidney
Loss of Excretory Function of Kidney
Inhibition of Erythropoiesis
Shortening of Red Cell Survival
CLINICAL AND LABORATORY FEATURES
TREATMENT
CDA TYPE I
CDA TYPE II
CDA TYPE III
CHAPTER 4:
Anaemias due to Excessive Red Cell Destruction
AETIOPATHOGENESIS
The Basic Lesion
Red Cell Destruction by Spleen
INHERITANCE
CLINICAL FEATURES
Heterogeneity
Exacerbation of Anaemia
Gallstones
Chronic Leg Ulcers
LABORATORY FEATURES
Examination of Peripheral Blood
Bone Marrow Examination
Osmotic Fragility Test
Limitations of Osmotic Fragility Test
Osmotic Fragility Test after Incubation
Autohaemolysis Test
Acidified Glycerol Lysis Time (AGLT)
Hypertonic Cryohaemolysis Test
Eosin-5-maleimide (EMA) Binding Test
Identification of Deficient Cytoskeletal Protein
DIAGNOSIS OF HEREDITARY SPHEROCYTOSIS
DIFFERENTIAL DIAGNOSIS
TREATMENT
GENERAL FEATURES AND APPROACH TO DIAGNOSIS
Classification
Haemoglobinopathies
Thalassaemias
Approach to Diagnosis of Disorders of Haemoglobin
Initial Peripheral Blood Examination
Haemoglobin Electrophoresis at Alkaline pH
Citrate Agar Electrophoresis at Acidic pH
High Performance Liquid Chromatography (HPLC)
Immunoassay for Haemoglobin Variants
Globin Chain Electrophoresis
Tests for Haemoglobin S
Estimation of HbA2
Estimation of Foetal Haemoglobin (HbF)
Intercellular Distribution of HbF
Tests for Inclusion Bodies
Globin Chain Synthesis Studies
THE THALASSAEMIAS
Classification of Thalassaemias
Molecular Basis of Thalassaemias
β Thalassaemias
α thalassaemias
Prevalence of Thalassaemias
Pathogenesis, Clinical Features, and Laboratory Features of Thalassaemias
β Thalassaemias
β Thalassaemia Major
Pathogenesis
Laboratory Features
β Thalassaemia Minor
Inheritance of β Thalassaemia with Structural Haemoglobinopathies
α Thalassaemias
Haemoglobin Bart's Hydrops Foetalis Syndrome
Haemoglobin H Disease
α Thalassaemia Carrier States
Thalassaemia Intermedia
Prevention of Thalassaemias
Various Strategies for Prevention of Thalassaemias
Carrier Screening
Prenatal Diagnosis
Techniques of DNA Analysis
Principles of Therapy in Thalassaemias
SICKLE CELL DISORDERS
Sickle Cell Anaemia
Prevalence of HbS
Pathogenesis
Clinical Features
Laboratory Features
Neonatal Screening for Sickle Cell Anaemia
Prenatal Diagnosis
Treatment
Prognosis
Sickle Cell Trait
GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY
Pathogenesis of Haemolysis
Genetics
Malaria and G6PD Deficiency
Clinical Features
Laboratory Features
Evidence of Haemolysis
Heinz Bodies
Tests for Detection of G6PD Deficiency
Tests for Detection of Heterozygotes
Differential Diagnosis
Treatment
CLASSIFICATION
Autoimmune Haemolytic Anaemias due to Warm-reacting Autoantibodies
Clinical Features
Laboratory Features
Differential Diagnosis
Treatment
Autoimmune Haemolytic Anaemias due to Cold-reacting Autoantibodies
Cold Agglutinin Disease
Paroxysmal Cold Haemoglobinuria (PCH)
Drug-induced Immune Haemolytic Anaemias
Drug Adsorption on Red Cell Membrane
Immune Complex or “Innocent Bystander” Mechanism
Production of Autoantibodies Against Red Cell Antigens
RH HAEMOLYTIC DISEASE OF THE NEWBORN
Pathogenesis
Clinical Features
Laboratory Features
Antenatal Investigations
Investigations of Newborn
Post-delivery Maternal Investigations
Treatment
Foetus
Neonate
Prevention of Rh Immunisation
ABO HAEMOLYTIC DISEASE OF NEWBORN
PATHOGENESIS
CLINICAL FEATURES
LABORATORY FEATURES
Peripheral Blood Examination
Urine Examination
Serological Studies
Sucrose Haemolysis Test
Acidified Serum Test (Ham Test)
Flow Cytometric Analysis of GPI-linked Proteins
TREATMENT
PROGNOSIS
MICROANGIOPATHIC HAEMOLYTIC ANAEMIA
MARCH HAEMOGLOBINURIA
CARDIAC HAEMOLYTIC ANAEMIA
PHYSICAL AGENTS
CHEMICAL AGENTS
INFECTIOUS AGENTS
Malaria
Clostridium welchii
NORMAL STRUCTURE AND FUNCTION OF SPLEEN
CAUSES OF SPLENOMEGALY
DIAGNOSTIC CRITERIA
SECTION III: DISORDERS OF WHITE BLOOD CELLS
CHAPTER 5:
Acute Leukaemias
DIAGNOSIS AND CLASSIFICATION
Predisposing Factors
Hereditary Factors
Acquired Factors
Mechanisms of Oncogenesis in Acute Leukaemias
Different Mechanisms of Leukaemogenesis
Classification of Acute Leukaemias
Salient Features of WHO Classification
Acute Lymphoblastic Leukaemia
Clinical Features of Acute Leukaemias
Due to Bone Marrow Failure
Due to Organ Infiltration
Other
Diagnosis of Acute Leukaemias
Morphology
Cytochemistry
Principles and Applications of Cytochemical Reactions
Immunological Cell Marker Analysis (immunophenotyping)
Cytogenetic Studies (karyotyping) and DNA ploidy studies
Molecular Genetic Studies
ACUTE LYMPHOBLASTIC LEUKAEMIA
Clinical Features
Classification
Morphological Classification of ALL (FAB Cooperative Group, 1976)
World Health Organization Classification (2001)
Laboratory Features
Peripheral Blood Examination
Bone Marrow Examination
Cytochemistry
Immunophenotyping
Cytogenetic Analysis
Molecular Genetic Studies
Other Investigations
Differential Diagnosis of ALL
Reactive Lymphocytosis due to Infections
Acute Myeloid Leukaemia
Leukaemic Phase of Non-Hodgkin's Lymphoma
Metastatic Tumours in Bone Marrow
Haematogones
Prognostic Factors in ALL
Total Leucocyte Count
Age
Immunophenotype
Cytogenetics
Other Bad Prognostic Indicators
Risk Categorisation in ALL
Treatment
Phases of Treatment in ALL (Box 5.6)
Supportive Care
Treatment of Relapse
Long-term Side Effects of Intensive Therapy
Haematopoietic Stem Cell Transplantation (HSCT)
Risk-adapted Therapy in ALL
Minimal Residual Disease (MRD) in ALL
Experience in India
ACUTE MYELOID LEUKAEMIA
Clinical Features
Classification
The French-American-British (FAB) Co-operative Group Classification
World Health Organization Classification
AML not Otherwise Categorised
Laboratory Features of AML
Peripheral Blood Examination
Bone Marrow Examination
Cytochemistry (See also “Acute Leukaemias—Diagnosis and Classification”)
Immunophenotyping (Table 5.15) See also under “Acute Leukaemias—Diagnosis and Classification”)
Cytogenetic Analysis
Differential Diagnosis
Leukaemoid Reaction
Myelodysplastic Syndrome (MDS)
Acute Lymphoblastic Leukaemia
Blast Crisis of Chronic Myelogenous Leukaemia (CML)
Prognostic Factors in AML
Treatment
Chemotherapy
Supportive Therapy
CHAPTER 6:
Myelodysplastic Syndromes
PATHOGENESIS
CLASSIFICATION OF MDS
French-American-British (FAB) Classification
World Health Organisation (WHO) Classification
CLINICAL FEATURES
LABORATORY FEATURES
Peripheral Blood Examination
Red Blood Cells
White Blood Cells
Platelets
Bone Marrow Examination
Bone Marrow Aspiration
Bone Marrow Biopsy
Cytogenetic Analysis
DIFFERENTIAL DIAGNOSIS
PROGNOSIS
TREATMENT
CHAPTER 7:
Chronic Myeloproliferative Disorders
PATHOGENESIS
CHRONIC MYELOID LEUKAEMIA
Pathogenesis
Incidence
Stages of CML
Chronic Phase of CML
Accelerated Phase of CML
Blast Crisis
Differential Diagnosis of CML
Chronic Phase
Blast Crisis
Course and Prognosis of CML
Treatment
Chronic Phase of CML
Accelerated Phase and Blast Crisis
POLYCYTHAEMIA VERA
Clinical Features
Laboratory Features
Peripheral Blood Examination
Bone Marrow Examination
Other Investigations
Differential Diagnosis
Course and Prognosis
Treatment
CHRONIC IDIOPATHIC MYELOFIBROSIS
ESSENTIAL THROMBOCYTHAEMIA
CHAPTER 8:
Chronic Lymphoid Leukaemias
CHRONIC LYMPHOCYTIC LEUKAEMIA
Clinical Features
Laboratory Features
Peripheral Blood Examination
Bone Marrow Examination
Immunophenotyping
Cytogenetic Analysis
Immunological Studies
Diagnosis
Differential Diagnosis
Reactive Lymphocytosis
Other Chronic Lymphoid Leukaemias
Complications of CLL
Prognosis
Treatment
PROLYMPHOCYTIC LEUKAEMIA
Clinical Features
Laboratory Features
Differential Diagnosis
Course and Prognosis
Treatment
HAIRY CELL LEUKAEMIA
Clinical Features
Laboratory Features
Peripheral Blood Examination
Bone Marrow Examination
Cytochemistry
Immunophenotypic Analysis
Histology of Spleen
Diagnosis and Differential Diagnosis
Complications of HCL
Course and Prognosis
Treatment
CHAPTER 9:
Plasma Cell Dyscrasias
INVESTIGATIONS IN PLASMA CELL DYSCRASIAS
Peripheral Blood Examination
Bone Marrow Examination
Investigation of Protein Abnormalities
Serum Protein Electrophoresis
Urine Protein Electrophoresis
Immunoelectrophoresis
Immunofixation
Quantitation of Monoclonal Immunoglobulins
Radiological Studies
MULTIPLE MYELOMA
Pathogenesis
Aetiology
Clinical Features
Skeletal System
Renal Failure
Anaemia
Infections
Haemorrhaglc Tendencies
Hyperviscosity syndrome
Laboratory Features
Peripheral Blood Examination
Bone Marrow Examination
Protein Alterations
Biochemical Abnormalities
Cytogenetic Analysis
Radiological Features
Diagnosis
Differential Diagnosis
Reactive Bone Marrow Plasmacytosis
Monoclonal Gammopathy of Undetermined Significance (MGUS)
Waldenström's Macroglobulinaemia (WM)
Lymphoproliferative Disorders with Monoclonal Gammopathy
Metastatic Carcinoma
Staging and Prognosis
Serum β2 microglobulin
Plasma Cell Labelling Index
Plasmablastic Morphology
Treatment
Causes of Death
Other Forms of Plasma Cell Myeloma
Solitary Plasmacytoma of Bone
Extramedullary (Extraosseous) Plasmacytoma
Smoldering Myeloma
Indolent Myeloma
Nonsecretory Myeloma
Plasma Cell Leukaemia
WALDENSTRöM's MACROGLOBULINAEMIA
Clinical Features
Laboratory Features
Peripheral Blood Examination
Bone Marrow Examination
Immunophenotyping
Serum and Urine Protein Electrophoresis
Tests for Haemostasis
Lymph Node Biopsy
Differential Diagnosis
Multiple Myeloma
Other Lymphoproliferative Disorders with IgM Monoclonal Gammopathy
Monoclonal Gammopathy of Undetermined Significance of IgM Type
Splenic Lymphoma with Villous Lymphocytes
Prognosis
Treatment
MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE
CHAPTER 10:
Malignant Lymphomas
HODGKIN's LYMPHOMA
Aetiopathogenesis
Clinical Features
Histopathology and Classification of Hodgkin's Lymphoma
Classical Reed-Sternberg Cell and its Variants
Classification of Hodgkin's Lymphoma
Staging of Hodgkin's Lymphoma
Staging Procedures
Course and Prognosis
Treatment
NON-HODGKIN's LYMPHOMA
Predisposing Factors
Pathogenesis
Classification of Non-Hodgkin's Lymphomas
Clinical Features of NHL
Laboratory Investigations
Lymph Node Biopsy
Haematological Investigations
Immunophenotyping
Cytogenetic Analysis
Gene Rearrangement Studies
Staging of NHL
Treatment of NHL
Low Grade NHL
Aggressive NHL
CHAPTER 11:
Quantitative and Qualitative Disorders of Leucocytes
NEUTROPHILIA
LEUCOERYTHROBLASTIC REACTION
LEUKAEMOID REACTION
NEUTROPENIA
Clinical Features
EOSINOPHILIA
BASOPHILIA
DISORDERS OF PHAGOCYTIC LEUCOCYTES CHARACTERISED BY MORPHOLOGIC CHANGES
Acquired Morphologic Changes in Neutrophils
Inherited Morphologic Changes
Pelger Huet Anomaly
Alder-Reilly Anomaly
May-Hegglin Anomaly
Chediak-Higashi Syndrome
Functional Disorders of Phagocytic Leucocytes
Hyper IgE or Job's Syndrome
Chronic Granulomatous Disease (CGD)
Myeloperoxidase (MPO) Deficiency
MONOCYTOSIS
STORAGE DISORDERS
Gaucher's Disease
Clinical Features
Diagnosis
Treatment
Niemann-Pick Disease
Diagnosis
Treatment
Langerhans’ Cell Histiocytosis
INFECTIOUS MONONUCLEOSIS
CLASSIFICATION OF IMMUNODEFICIENCY DISEASES
Primary Immunodeficiency
X-linked Agammaglobulinaemia (Bruton's disease)
Selective Deficiency of IgA
Transient Hypogammaglobulinaemia of Infancy
Common Variable Immunodeficiency
Digeorge's Syndrome (Thymic hypoplasia)
Severe Combined Immunodeficiency Disease (SCID)
Wiskott-Aldrich Syndrome
Ataxia Telangiectasia
Secondary Immunodeficiency
Immunological Abnormalities in Acquired Immunodeficiency Syndrome (AIDS)
CHAPTER 12:
Haematopoietic Stem Cell Transplantation
TYPES OF HAEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT)
Allogeneic HSCT
Indications for Allogeneic HSCT
General Principles of Allogeneic HSCT
Complications:
Autologous HSCT
Indications for Autologous HSCT
Complications
SOURCES OF HAEMATOPOIETIC STEM CELLS
Peripheral Blood Stem Cell Mobilisation and Harvesting
Bone Marrow Harvesting
RECENT ADVANCES IN HSCT
Umbilical Cord Blood Transplantation
Non-myeloablative Allogeneic HSCT
SECTION IV: DISORDERS OF HAEMOSTASIS
CHAPTER 13:
Approach to the Diagnosis of Bleeding Disorders
CLINICAL EVALUATION
LABORATORY EVALUATION
LABORATORY TESTS
Screening Tests for Primary Haemostasis
Bleeding Time (BT)
PFA (Platelet Function Analyzer)-100
Platelet Count
Complete Blood Count and Blood Smear
Screening Tests for Secondary Haemostasis
Collection of Blood Sample for Coagulation Studies:
Prothrombin Time
Activated Partial Thromboplastin Time (APTT)
Thrombin Time
SPECIFIC TESTS
Specific Tests for Primary Haemostatic Disorders
Tests for specific Platelet Functions
Specific Tests for Coagulation Phase
Mixing Study Based on PT or APTT
Thromboplastin Generation Test (TGT)
Quantitative Estimation of Fibrinogen
Coagulation Factor Assays
F XIII Qualitative Assay
Paracoagulation Tests
Tests for Fibrinolysis
Detection of Fibrinogen/Fibrin Degradation Products by Latex Agglutination Test
Detection of Cross-linked Fibrin D-dimers by Latex Agglutination Test
CHAPTER 14:
Bleeding Disorders Caused by Abnormalities of Blood Vessels (The Vascular Purpuras)
ANAPHYLACTOID PURPURA (HENOCH SCHöNLEIN PURPURA, ALLERGIC PURPURA)
INFECTIONS
SCURVY
SENILE PURPURA
PURPURA SIMPLEX
MECHANICAL PURPURA
HEREDITARY HAEMORRHAGIC TELANGIECTASIA (OSLER-WEBER-RENDU DISEASE)
CHAPTER 15:
Bleeding Disorders Caused by Abnormalities of Platelets
THROMBOCYTOPENIA
Idiopathic Thrombocytopenic Purpura (ITP)
Pathogenesis
Clinical Features
Laboratory Features
Differential Diagnosis
Diagnosis
Treatment
Alloimmune Neonatal Thrombocytopenia
Post-transfusion Purpura
Thrombotic Thrombocytopenic Purpura
Haemolytic Uraemic Syndrome
Massive Transfusion
Thrombocytopenia due to Increased Platelet Sequestration or Pooling
Pseudothrombocytopenia
Evaluation of a Thrombocytopenic Patient
THROMBOCYTOSIS
DISORDERS OF PLATELET FUNCTION
Inherited Disorders of Platelet Function
Bernard-Soulier Syndrome
Glanzmann's Thrombasthenia
Storage Pool Deficiency
Defective Thromboxane Synthesis (Aspirin-like defect)
Acquired Disorders of Platelet Function
Drugs
Myeloproliferative Disorders
Paraproteinaemias
Uraemia
CHAPTER 16:
Disorders of Coagulation
HAEMOPHILIA A
Inheritance
Clinical Features
Laboratory Features
Coagulation Profile
Factor VIII: C Assay
Differential Diagnosis
Therapy of Haemophilia A
Therapeutic Agents
Management
Complications of Replacement Therapy
Molecular Genetics of Haemophilia A
Genetic Defects in Haemophilia A
Detection of Carriers
Phenotypic Methods
Genotypic Methods
Prenatal Diagnosis
Preimplantation Diagnosis
Non-invasive Prenatal Diagnosis
VON WILLEBRAND DISEASE
Classification
Type I vWD (classical vWD)
Type II vWD (variant vWD)
Type III
Clinical Features of vWD
Laboratory Features
Treatment of vWD
HAEMOPHILIA B
INHERITED DISORDERS OF FIBRINOGEN
Hereditary Afibrinogenaemia
Hypofibrinogenaemia
Dysfibrinogenaemias
VIT K DEFICIENCY
Haemorrhagic Disease of the Newborn
LIVER DISEASE (CIRRHOSIS OF LIVER)
DISSEMINATED INTRAVASCULAR COAGULATION
Aetiology
Pathogenesis
Clinical Features
Laboratory Features
Acute DIC
Chronic DIC
General Principles of Therapy
ACQUIRED INHIBITORS OF COAGULATION (CIRCULATING ANTICOAGULANTS)
Specific Inhibitors
F VIII Inhibitors
Non-Specific Inhibitors
HEPARIN THERAPY
Low Molecular Weight Heparins (LMWH)
ORAL ANTICOAGULANTS
OTHER ACQUIRED COAGULATION DISORDERS
Renal Diseases
Paraproteinaemias
Amyloidosis
Cardiopulmonary Bypass
Massive Transfusion of Stored Blood
SECTION V: BLOOD TRANSFUSION
CHAPTER 17:
Blood Group Systems
ABO SYSTEM
Antigens of the ABO System
Antibodies of the ABO System
THE RH SYSTEM
Antigens of the Rh System
Rh Antibodies
CHAPTER 18:
Serologic and Microbiologic Techniques
SEROLOGIC TECHNIQUES
ABO Grouping
Slide Test (Forward grouping or cell grouping)
Tube Method
Microplate Method
False Reactions in ABO Grouping
Rh D Grouping
Compatibility Test (Cross match)
False Reactions in Compatibility Testing
Limitations of Cross Match
Emergency Cross Match
Antibody Screening and Identification
MICROBIOLOGIC TECHNIQUES
Hepatitis B Virus (HBV)
Hepatitis C Virus (HCV)
Human Immunodeficiency Virus (HIV)
Syphilis
Malaria Parasite
CHAPTER 19:
Collection of Donor Blood, Processing and Storage
TYPES OF BLOOD DONORS
CRITERIA FOR SELECTION OF BLOOD DONORS
Age
Donation Interval
Volume of Donation
Pregnancy and Lactation
Infectious Diseases
HIV-1 and HIV-2
Hepatitis
Malaria
Illness
Drugs
Dentistry
Skin Piercing
Blood Transfusion
Immunization
Physical Examination
Laboratory Test for Anaemia
COLLECTION OF DONOR BLOOD
Equipments and Materials
Technique
Donor Reactions
PROCESSING OF DONOR BLOOD
STORAGE OF DONOR BLOOD UNIT
CHAPTER 20:
Whole Blood, Blood Components and Blood Derivatives
WHOLE BLOOD
BLOOD COMPONENTS
Red Cell Components
Packed Red Cells
Red Cells in Additive Solution (Red cell suspension)
Leucocyte-poor red Cells
Washed Red Cells
Frozen Red Cells
Irradiated Red Cells
Platelets
Platelet Concentrate (Random Donor Platelets)
Plateletpheresis (Single donor platelets)
Granulocyte Concentrate
Plasma Components
Fresh Frozen Plasma (FFP)
Cryoprecipitate
BLOOD DERIVATIVES
Human Albumin Solutions
F VIII Concentrate
F IX Concentrate
Prothrombin Complex Concentrate (PCC)
Immunoglobulins
Non-specific or “Normal” Immunoglobulins
Specific Immunoglobulins
CHAPTER 21:
Transfusion of Blood to the Recipient
SELECTION OF DONOR BLOOD FOR WHOLE BLOOD OR PACKED RED CELL TRANSFUSION
SELECTION OF DONOR PLASMA
ANTIBODY SCREENING AND IDENTIFICATION
COMPATIBILITY TEST
ISSUE OF DONOR BLOOD UNIT
TRANSFUSION OF BLOOD UNIT
CHAPTER 22:
Adverse Effects of Transfusion
IMMEDIATE COMPLICATIONS
Febrile Non-haemolytic Transfusion Reaction (FNHTR)
Haemolytic Transfusion Reaction (HTR)
Investigation of a Haemolytic Transfusion Reaction
Allergic Reactions
Anaphylactic Reaction
Transfusion Associated Lung Injury (TRALI)
Circulatory Overload
Bacterial Contamination of Donor Unit
DELAYED COMPLICATIONS
Delayed Haemolytic Transfusion Reaction
Post-transfusion Purpura
Transfusion Associated Graft vs. Host Disease (GvHD)
Transmission of Infectious Organisms
Hepatitis B Virus (HBV)
Hepatitis C Virus (HCV)
Human Immunodeficiency Virus
Treponema Pallidum
Plasmodium Species
Iron Overload
COMPLICATIONS ASSOCIATED WITH MASSIVE BLOOD TRANSFUSION
CHAPTER 23:
Autologous Transfusion
PREDEPOSIT AUTOLOGOUS BLOOD TRANSFUSION
ACUTE NORMOVOLAEMIC HAEMODILUTION
BLOOD SALVAGE
CHAPTER 24:
Alternatives to Blood Transfusion
HAEMATOPOIETIC GROWTH FACTORS (HGFS)
Erythropoietin
Granulocyte Macrophage-colony Stimulating Factor (GM-CSF)
Granulocyte-colony Stimulating Factor (G-CSF)
RED CELL SUBSTITUTES
Haemoglobin Solutions
Disadvantages of Haemoglobin Solutions
Perfluorocarbons (PFCs)
INDEX
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