Clinical Applications

Iron Overload and Tissue Damage - In addition to the oxygen-carrying capacity of iron, plasma proteins known as transferrin and ferritin serve as protein escorts for iron ions, since iron ions can otherwise damage molecules in cells and blood. Consequently, plasma contains virtually no free iron ions. However, there are no natural mechanisms regulating excess iron concentration. Additional sources of iron, therefore increase the risk of iron overload as ferritin and transferrin approach saturation. This may result in diseases of the heart, liver, pancreatic Islets and gonads. Though rarely pathogenic, iron-feeding microbes may also flourish and over-populate, thereby placing greater burdon on the body.

Reticulocyte Count - Used to establish the rate of erythropoiesis (RBC synthesis). Normal concentration is usually 0.5% - 1.5% of RBCs. Test results indicating a low reticulocyte count in an anemic individual suggests either a deficiency of EPO (erythropoietin) or inadequate bone marrow response to EPO, which may indicate a nutritional deficiency or leukemia. By contrast, a high reticulocyte count suggests a positive bone marrow response to blood loss or iron therapy, as well as blood-doping by athletes.

Bone Marrow Transplant - Used to treat a variety of blood disorders and cancers, bone marrow transplants require initial chemotherapy and radiation to destroy defective bone marrow prior to surgery. Stem cells from donor marrow then seed the bone cavities.

Complete Blood Count - Used to test for anemia and infections CBC assesses RBCs, WBCs and platelet concentrations per microliter of whole blood, as well as hemoglobin concentration in g/100mL of blood. Normal hemoglobin values are as follows:

• Infants = 14-20g/100mL
• adult females = 12-16g/100mL
• adult males = 13.5-18g/100mL

Anticoagulants - Prescribed for individuals at risk of blood clotting, anticoagulants like Heparin and Warfarin (aka coumadin) are Vitamin K antagonists that inhibit the 4 hepatocytic clotting factors associated with vitamin K.

Hemolytic Disease of the Newborn - A problem associated with blood Rh incompatibility, HDN begins when an expectant mother acquires anti-Rh antibodies from a previous pregnancy in which the first fetus was Rh⁺. If the second fetus is also Rh⁺, the mothers acquired anti-Rh antibodies will pass through the placenta into the fetal blood stream and hemolysis will occur.

Anemias

Iron-Deficiency Anemia The most common anemia-type, resulting from:

• inadequate iron absorption
• Iron loss
• increased iron requirement
• diet

Pernicious Anemia - Poor hemopoietic activity resulting from vitamin B₁₂ deficiency.

Hemorrhagic Anemia - Excess loss of RBCs via wound or menstral period.

Hemolytic Anemia - Premature hemolysis of RBCs due to either abnormal RBC enzymes or transfusion.

Thalassemia - Poor hemoglobin synthesis, particularly among mediterranian populations.

Aplastic Anemia - Gamma radiation and medications used to inhibit enzymes destroy red bone marrow, which leads to aplastic anemia.

Sickle-Cell Disease - An abnormal hemoglobin (Hb-S) releases oxygen from RBCs, which then take on a sickle shape. Erythropoiesis cannot keep up with hemolysis and oxygen deprivation leads to tissue damage.

Hemophilia - blood clotting disorder. There are 3 types:

• A - Most common, particularly in males, in which clotting factor VIII is absent.
• B - Absence of clotting factor IX, also in males
• C - Absence of clotting factor XI. Affects males and females.

Disseminated Intravascular Clotting - Hemostasis disorder. Unregulated blood clotting and hemorrhage charactized by both.

Leukemia - The 2 types are:

• Acute - Uncontrolled production of immature leukocytes.
• Chronic - Mature leukocytes exceed normal lifespan to overpopulate. associated with HTLV-1 (Human T Cell Leukemia-Lymphoma virus-1))