Stomatocytosis And Anemia By Hypophosphatemia

Stomatocytosis (cup- or bowl-shaped erythrocytes) and hypophosphatemia result in hemolytic anemia associated with red cell membrane of defects.

Stomatocytosis (cup- or bowl-shaped erythrocytes) and hypophosphatemia result in hemolytic anemia associated with red cell membrane of defects. The stomatocytosis stomatocytosis is a rare disease of the erythrocytes, in which the central light of the erythrocytes Hof mouth or altered slit-shaped. These cells are found in hereditary or acquired hemolytic anemias. The symptoms are a result of anemia. In rare hereditary stomatocytosis is an autosomal dominant inherited disease that causes severe hemolytic anemia and already occurs very early in childhood. Approximately 20-30% of circulating red blood cells are stomatocytes. The erythrocyte membrane is hyperpermeable for monovalent cations (sodium and potassium), however for divalent cations and anions, the permeability is normal. The osmotic resistance of erythrocytes is reduced, however, the Autohämolyse is increased, whereby the addition of glucose did not regularly leads to a correction. Splenectomy improves anemia in some cases. The acquired stomatocytosis in connection with a hemolytic anemia occurs primarily after excessive alcohol consumption. Within two weeks after the alcohol intake, the stomatocytes disappear in the peripheral blood as well as the hemolysis. Anemia due to hypophosphatemia The deformability of the red blood cells depends on the intracellular ATP content. Since the phosphate content affects the ATP content in the erythrocytes in the serum, serum phosphate levels lead <0.5 mg / dl (<0.16 mmol / l) in a reduction of ATP in erythrocytes. To the complex metabolic consequences of hypophosphatemia include a reduction of 2,3-diphosphoglycerate, a leftward shift in the O2 dissociation curve, decreased glucose utilization and increased lactate production. The resulting rigid, non-elastic erythrocytes can be easily damaged in the capillary. As a result, hemolysis and small spherical erythrocytes occur (Mikrosphärozytose). A severe hypophosphatemia can in alcohol withdrawal, diabetes mellitus, starting the food intake by hunger situations in which (diuretic) recovery period after severe burns, in hyperalimentation, severe respiratory alkalosis and in uremic dialysis patients taking antacids occur. Administration of phosphate protects against anemia and causes the regression and should be used in patients at risk for the development of hypophosphatemia.

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