Erythrocyte production : Hematologic problems : Clinical manifestations

Erythrocyte production

  • Life span of an RBC is 120 days
  • Three alterations in erythropoiesis may decrease RBC production:
    • Decreased hemoglobin synthesis
    • Defective DNA synthesis in RBCs
    • Diminished availability of erythrocyte precursors

Hematologic problems

  • Sickle cell disease has a high incidence among African Americans.
  • Thalassemia has a high incidence among African Americans and people of Mediterranean origin.
  • Tay-Sachs disease has the highest incidence in families of Eastern European Jewish origin, especially the Ashkenazi Jews.
  • Pernicious anemia has a high incidence among Scandinavians and African Americans.

Clinical manifestations

  • Caused by body’s response to tissue hypoxia
    • Manifestations vary based on rate of development, severity of anemia, presence of co-existing disease
  • Hemoglobin (Hgb) levels are used to determine severity of anemia

Integumentary manifestations

  • Pallor
    • Decreased hemoglobin
    • Decreased blood flow to the skin
  • Jaundice
    • Increased concentration of serum bilirubin
  • Pruritus
    • Increased serum and skin bile salt concentrations

Cardiopulmonary manifestation

  • Result from additional attempts by heart and lungs to provide adequate O2 to tissues
  • Cardiac output maintained by increasing heart rate and stroke volume


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