{"id":1074,"date":"2016-12-08T21:22:31","date_gmt":"2016-12-08T20:22:31","guid":{"rendered":"http:\/\/www.newslab.sk\/2016\/12\/08\/anemie-laboratorna-diagnostika-najcastejsie-sa-vyskytujucich-anemii\/"},"modified":"2017-10-04T14:54:20","modified_gmt":"2017-10-04T12:54:20","slug":"anemias-laboratory-diagnosis-of-the-most-common-types-of-anemia","status":"publish","type":"post","link":"https:\/\/www.newslab.sk\/en\/anemias-laboratory-diagnosis-of-the-most-common-types-of-anemia\/","title":{"rendered":"Anemias \u2013 laboratory diagnosis of the most common types of anemia"},"content":{"rendered":"<pre><strong><span style=\"color: #ff0000;\">*All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf \r\nattachment at the end of the paper. <\/span><\/strong><\/pre>\n<p>&nbsp;<\/p>\n<p><strong>Charakteristika<\/strong><br \/>\nAn\u00e9mia je definovan\u00e1 ako chorobn\u00fd stav vznikaj\u00faci zn\u00ed\u017een\u00edm koncentr\u00e1cie hemoglob\u00ednu v 1 litri perif\u00e9rnej krvi pod 130 g u mu\u017eov a pod 120 g u \u017eien. Kone\u010dn\u00fdm d\u00f4sledkom an\u00e9mie je porucha prenosu kysl\u00edka do tkan\u00edv (1).<\/p>\n<p><strong>Klasifik\u00e1cia<\/strong><br \/>\nAn\u00e9mie klasifikujeme pod\u013ea morfologick\u00fdch krit\u00e9ri\u00ed alebo pod\u013ea patofyziologick\u00fdch krit\u00e9ri\u00ed, ktor\u00e9 sa navz\u00e1jom pri diagn\u00f3ze dop\u013a\u0148aj\u00fa (tabu\u013eka 1, 2).<\/p>\n<p><em>A. MIKROCYTOV\u00c1 AN\u00c9MIA<\/em><br \/>\n<strong>1. Sideropenick\u00e1 an\u00e9mia \u2013 an\u00e9mia z nedostatku \u017eeleza<\/strong><br \/>\n<strong>Metabolizmus \u017eeleza<\/strong><\/p>\n<p>Metabolizmus \u017eeleza (Fe) predstavuje kask\u00e1du \u2013 absorpcia, transport, utiliz\u00e1cia, reutiliz\u00e1cia a skladovanie \u017eeleza.<br \/>\n<strong>1. Absorpcia:<\/strong> s\u00favis\u00ed s dostupnos\u0165ou \u017eeleza v potrave, absorpciou v GIT-e, je regulovan\u00e1 stavom Fe v organizme a aktivitou erytropo\u00e9zy.<br \/>\n<strong>2. Transport:<\/strong> transportn\u00e9 Fe \u2013 plazmov\u00fd pool je najakt\u00edvnej\u0161\u00ed kompartment \u017eeleza, anatomicky a funk\u010dne k\u013e\u00fa\u010dov\u00fd v cykle Fe. \u017delezo je viazan\u00e9 na prote\u00edn-transfer\u00edn, ktor\u00fd smeruje \u017eelezo k \u0161pecifick\u00fdm cie\u013eom v organizme, prostredn\u00edctvom v\u00e4zby na transfer\u00ednov\u00e9 receptory buniek (TfR). Transfer\u00edn kontinu\u00e1lne\u00a0 transportuje Fe v cykloch: enterocyt \u2013 erytroblast, enterocyt \u2013 makrof\u00e1g alebo makrof\u00e1g \u2013 erytroblast.<br \/>\n<strong>3. Intracelul\u00e1rny metabolizmus Fe:<\/strong> endocyt\u00f3za, uvo\u013enenie a zabudovanie \u017eeleza do hemoglob\u00ednu \u00a0a n\u00e1sledn\u00fd n\u00e1vrat Tf, do plazmy (2, 3, 4). \u00a0V hepatocytoch sa prij\u00edma Fe komplex Tf-Fe-TfR a zabuduje sa ako z\u00e1sobn\u00e1 forma Fe \u2013 ferit\u00edn.<br \/>\n<strong>4. Skladovanie:<\/strong> \u017eelezo viazan\u00e9 na transfer\u00edn tvor\u00ed 80 % funk\u010dn\u00e9ho kompartmentu dostupn\u00e9ho pre erytropo\u00e9zu a in\u00e9 tkaniv\u00e1. Intracelul\u00e1rne Fe je skladov\u00fdm kompartmentom, ktor\u00fd predstavuje \u00a0rezervu. Po vstupe komplexu Tf-Fe alebo hemoglob\u00edn-Fe\u00a0 doch\u00e1dza k uvo\u013eneniu v\u00e4zby a Fe prech\u00e1dza do intracelul\u00e1rneho labiln\u00e9ho poolu Fe, je zabudovan\u00e9 do ferit\u00ednu, nesk\u00f4r do hemosider\u00ednu alebo je uvo\u013enen\u00e9 do plazmy \u00a0(1, 3, 10).<\/p>\n<p><strong>B<\/strong><strong>io<\/strong><strong>c<\/strong><strong>h<\/strong><strong>e<\/strong><strong>m<\/strong><strong>i<\/strong><strong>c<\/strong><strong>k<\/strong><strong>\u00e9 parametre pri diagnostike an\u00e9mi\u00ed<\/strong><\/p>\n<p><strong>\u017delezo<br \/>\n<\/strong>pr\u00ed\u010diny spojen\u00e9 s nedostatkom (tabu\u013eka 3)<\/p>\n<ul>\n<li>v plazme naviazan\u00e9 na transfer\u00edn (2 Fe na 1 mol )<\/li>\n<li>prekro\u010den\u00edm v\u00e4zobnej kapacity nast\u00e1va intoxik\u00e1cia \u017eelezom; pri naroden\u00ed s\u00fa hodnoty 27 \u201336 \u00b5mol\/l, o nieko\u013eko hod\u00edn \u00a0klesaj\u00fa pod 18 \u00b5mol\/l; v priebehu gravidity dost\u00e1va fetus od matky 140 \u2013 160 \u00b5mol \u017eeleza<\/li>\n<li>hladina s\u00e9rov\u00e9ho \u017eeleza m\u00e1 cyklick\u00e9 kol\u00edsanie v priebehu d\u0148a (r\u00e1no je o 10 \u2013 30 % vy\u0161\u0161ia ako ve\u010der!)<\/li>\n<li>celkov\u00e1 plazmatick\u00e1 \u00a0hotovos\u0165 \u00a0\u017eeleza je 0,5 \u2013 0,7 mmol, r\u00fdchlos\u0165 pre- meny je 60 \u2013 120 min\u00fat<\/li>\n<li>na erytropo\u00e9zu sa vyu\u017eije 80 \u2013 90 % denn\u00e9ho obratu \u017eeleza<\/li>\n<\/ul>\n<p><strong>Ferit\u00edn \u2013 reaktant ak\u00fatnej f\u00e1zy<br \/>\n<\/strong>pr\u00ed\u010diny zmien hodnoty ferit\u00ednu (tabu\u013e ka 5)<\/p>\n<ul>\n<li>prote\u00edn skladuj\u00faci \u017eelezo v tkaniv\u00e1ch<\/li>\n<li>vysok\u00e1 koncentr\u00e1cia je v hepatocytoch, v recykla\u010dn\u00fdch erytrocytov\u00fdch centr\u00e1ch pe\u010dene, sleziny a kostnej dreni, v ktor\u00fdch sl\u00fa\u017ei \u017eelezo ferit\u00ednu ako r\u00fdchla vyu\u017eite\u013en\u00e1 z\u00e1soba \u017eeleza na erytropo\u00e9zu<\/li>\n<li>mal\u00e9 mno\u017estvo sa uvo\u013e\u0148uje do plazmy<\/li>\n<\/ul>\n<p><strong>Vhodn\u00e9 vy\u0161etri\u0165 pri:<\/strong><\/p>\n<ul>\n<li>an\u00e9mii z nedostatku \u017eeleza<\/li>\n<li>defekte v skladovan\u00ed \u017eeleza<\/li>\n<li>kontrole peror\u00e1lnej terapie \u017eelezom<\/li>\n<li>diferenci\u00e1lnej diagnostike an\u00e9mi\u00ed<\/li>\n<li>h\u013eadan\u00ed rizikov\u00fdch pacientov s nedostatkom \u017eeleza (tehotn\u00e9, darcovia, dialyzovan\u00ed pacienti)<\/li>\n<li>pred\u00e1vkovan\u00ed \u017eelezom<\/li>\n<\/ul>\n<p><strong>Transfer\u00edn<\/strong><\/p>\n<ul>\n<li>hlavn\u00fd transportn\u00fd prote\u00edn \u017eeleza v plazme<\/li>\n<li>negat\u00edvny reaktant ak\u00fatnej f\u00e1zy<\/li>\n<li>jedna molekula via\u017ee dva at\u00f3my Fe 3+ v spojen\u00ed s ani\u00f3nom, pri\u010dom ceruloplazm\u00edn oxiduje Fe 2+ na Fe 3+ pri jeho inkorpor\u00e1cii do transfer\u00ednu<\/li>\n<li>je syntetizovan\u00fd v pe\u010deni, v malom mno\u017estve v RES, testes a ov\u00e1ri\u00e1ch<\/li>\n<li>r\u00fdchle proliferuj\u00face bunky (erytroidn\u00fd rad kostnej drene, trofoblast) maj\u00fa na svojom povrchu receptory pre transfer\u00edn-\u017eelezo komplex, ktor\u00fdm zachyt\u00e1vaj\u00fa transportovan\u00e9 \u017eelezo na svoju potrebu<\/li>\n<\/ul>\n<p><strong><br \/>\nSatur\u00e1cia transfer\u00ednu<\/strong><\/p>\n<ul>\n<li>ud\u00e1va pomer koncentr\u00e1cie \u017eeleza v s\u00e9re a v\u00e4zbovej kapacity \u017eeleza (tabu\u013eka 7)<\/li>\n<\/ul>\n<p><strong><br \/>\nSolubiln\u00fd transfer\u00ednov\u00fd receptor<\/strong><\/p>\n<ul>\n<li>hlavn\u00fd medi\u00e1tor presunu Fe do bunky (dim\u00e9r s 2 identick\u00fdmi subjednotkami)<\/li>\n<li>vznik \u2013 proteol\u00fdza transfer\u00ednov\u00e9ho receptora na extracelul\u00e1rnej dom\u00e9ne via\u017ee transfer\u00edn s 2 molekulami Fe&#8230;, prenos \u00a0Fe do cytozolu bunky<\/li>\n<li>80 % TfR je na erytroidn\u00fdch progenitorov\u00fdch \u00a0bunk\u00e1ch<\/li>\n<li>Klinick\u00fd v\u00fdznam: odl\u00ed\u0161enie siderop\u00e9nie pri z\u00e1palov\u00fdch ochoreniach od deficitu Fe (tabu\u013eka 8, 9)<\/li>\n<\/ul>\n<p><strong>Pomer solubiln\u00fd transfer\u00ednov\u00fd receptor\/log ferit\u00ednu<\/strong><\/p>\n<ul>\n<li>sTrfR\/FERIT<\/li>\n<\/ul>\n<p><strong>Celkov\u00e1 v\u00e4zbov\u00e1 kapacita \u017eeleza<br \/>\n<\/strong>V\u00e4zbov\u00e1 kapacita \u017eeleza ud\u00e1va, ak\u00e9 najv\u00e4\u010d\u0161ie mno\u017estvo \u00a0\u017eeleza je schopn\u00fd transfer\u00edn naviaza\u0165:<\/p>\n<ul>\n<li>je mo\u017en\u00e9 stanovi\u0165 TIBC (total iron binding capacity) \u2013 celkov\u00fa v\u00e4zbov\u00fa kapacitu \u017eeleza a<\/li>\n<li>UIBC (unsaturated binding capacity) \u2013 vo\u013en\u00fa v\u00e4zbov\u00fa kapacitu \u017eeleza. Napriek tomu, \u017ee vy\u0161etrenie transfer\u00ednu a v\u00e4zbovej kapacity \u017eeleza s\u00fa dve rozdielne vy\u0161etrenia a ich v\u00fdsledky sa vyjadruj\u00fa v r\u00f4znych jednotk\u00e1ch (transfer\u00ednu v g\/l a v\u00e4zbovej kapacity Fe v \u03bcmol\/l), ide v podstate o meranie<br \/>\ntoho ist\u00e9ho ukazovate\u013ea (9).<br \/>\nPr\u00ed\u010diny zv\u00fd\u0161enej, resp. zn\u00ed\u017eenej hodnoty s\u00fa uveden\u00e9 v tabu\u013eke 10.<\/li>\n<\/ul>\n<p><strong>Erytropoet\u00edn<\/strong><\/p>\n<ul>\n<li>glykoprote\u00ednov\u00fd horm\u00f3n tvoren\u00fd v obli\u010dk\u00e1ch, ktor\u00fd stimuluje erytropo\u00e9zu<\/li>\n<li>podnetom \u00a0na zv\u00fd\u0161en\u00fa tvorbu je hypoxia (tabu\u013eka 11)<\/li>\n<\/ul>\n<p><strong>Hepcid\u00edn<\/strong><\/p>\n<ul>\n<li>peptidov\u00fd horm\u00f3n syntetizovan\u00fd v pe\u010deni, hlavn\u00fd regul\u00e1tor metabo- lizmu, respekt\u00edve absorpcie \u017eeleza, a aj jeho homeost\u00e1zy \u00a0(objaven\u00fd v roku 2000), synt\u00e9za prebieha v hepatocytoch, v n\u00edzkom percente aj v adipocytoch, makrof\u00e1goch a mozgu, je d\u00f4le\u017eit\u00fd na autokrinn\u00fa regul\u00e1ciu \u017eeleza na lok\u00e1lnej tkanivovej \u00farovni<\/li>\n<li>nedostatok hepcid\u00ednu sp\u00f4sobuje pre\u0165a\u017eenie organizmu \u017eelezom, teda ochorenia ako hemochromat\u00f3za<\/li>\n<li>priamo inhibuje prote\u00edn feroport\u00edn, ktor\u00fd transportuje \u017eelezo v bunk\u00e1ch \u010drevnej steny<\/li>\n<li>regulovan\u00fd je koncentr\u00e1ciou \u00a0\u017eeleza a mierou erytropo\u00e9zy<\/li>\n<li>nadbytok \u017eeleza stimuluje jeho produkciu, zv\u00fd\u0161en\u00e1 produkcia tohto horm\u00f3nu \u00a0n\u00e1sledne \u00a0zabr\u00e1ni absorpcii \u00a0\u017eeleza (7, 8)<strong>2<\/strong><strong>. <\/strong><strong>A<\/strong><strong>n<\/strong><strong>\u00e9<\/strong><strong>m<\/strong><strong>i<\/strong><strong>e pri chronick\u00fdch ochoreniach<\/strong><\/li>\n<li>chronick\u00e9 infekcie (TBC, osteomyelitis, infek\u010dn\u00e1 endokardit\u00edda (mykotick\u00e9, v\u00edrusov\u00e9), AIDS) (\u017eelezo ako hlavn\u00fd rastov\u00fd faktor invaduj\u00facich patog\u00e9nov)<\/li>\n<li>z\u00e1palov\u00e9 ochorenia \u00a0(ulcer\u00f3zna \u00a0kolit\u00edda, region\u00e1lna \u00a0enterit\u00edda)<\/li>\n<li>syst\u00e9mov\u00e9 ochorenia (lupus erytematodes, sklerodermia, vaskulit\u00eddy)<\/li>\n<li>n\u00e1dorov\u00e9 ochorenia (sol\u00eddne n\u00e1dory, lymf\u00f3my) \u2013 infiltr\u00e1cia kostnej drene<\/li>\n<li>chronick\u00e1 ren\u00e1lna insuficiencia \u2013 zn\u00ed\u017een\u00e1 tvorba erytropet\u00ednu<\/li>\n<li>hepat\u00e1lne ochorenie \u2013 porucha metabolizmu lipidov, bielkov\u00edn<\/li>\n<li>laborat\u00f3rne ukazovatele (tabu\u013eka 13)<br \/>\nZ\u00e1kladn\u00fa diferenci\u00e1lnu diagnostiku mikrocit\u00e1rnych an\u00e9mi\u00ed uv\u00e1dza tabu\u013eka 14.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><em>B. MAKROCYTOV\u00c1 AN\u00c9MIA<\/em><br \/>\n<strong>1. Makrocytov\u00e1 an\u00e9mia s megaloblastovou krvotvorbou (tabu\u013eka 15)<\/strong><\/p>\n<ul>\n<li>an\u00e9mia z nedostatku vitam\u00ednu B12 (pernici\u00f3zna an\u00e9mia) a kyseliny listovej<\/li>\n<li>patofyziologicky je zn\u00ed\u017een\u00e1 produkcia krvn\u00fdch elementov na defektn\u00fa matur\u00e1ciu s n\u00e1slednou poruchou synt\u00e9zy DNA<\/li>\n<li>okrem erytropo\u00e9zy postihnut\u00fd aj granulocytov\u00fd a megakaryocytov\u00fd rad<\/li>\n<li>z\u00e1kladn\u00e1 diagnostika (tabu\u013eka 16)<\/li>\n<\/ul>\n<p><strong>2<\/strong><strong>. Makrocytov\u00e1 an\u00e9mia s normoblastovou krvotvorbou (tabu\u013e ka 17)<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><em>C. NORMOCYTOV\u00c1 AN\u00c9MIA<\/em><\/p>\n<p>K normocytov\u00fdm an\u00e9mi\u00e1m patr\u00ed rozsiahla skupina an\u00e9mi\u00ed z prim\u00e1rnej a sekund\u00e1rnej poruchy kostnej drene. Av\u0161ak k naj\u010dastej\u0161iemu \u00a0typu normocytov\u00fdch an\u00e9mi\u00ed patria an\u00e9mie z ak\u00fatneho krv\u00e1cania (1). Ak\u00fatne posthemoragick\u00e9 \u00a0an\u00e9mie vznikaj\u00fa v d\u00f4sledku rozsiahleho ak\u00fatneho krv\u00e1cania, po rupt\u00fare ve\u013ek\u00fdch ciev, sleziny, krv\u00e1can\u00ed z ezofage- \u00e1lnych varixov \u010di ako n\u00e1sledok extrauterinnej gravidity (1, 10). Maj\u00fa normocytov\u00fd \u00a0normochr\u00f3mny \u00a0charakter a v po\u010diato\u010dnej f\u00e1ze nedoch\u00e1dza \u00a0k zv\u00fd\u0161eniu retikulocytov. Postupne sa v krvnom obraze objav\u00ed trombocyt\u00f3za a leukocyt\u00f3za ako prejav aktiv\u00e1cie sympatiku a v d\u00f4sledku aktiv\u00e1cie kostnej drene (1, 10). Chronick\u00e9 posthemoragick\u00e9 an\u00e9mie postupn\u00fdmi a priebe\u017en\u00fdmi stratami \u00a0krvi, ktor\u00e9 sa prejavia spo\u010diatku obrazom \u00a0normocytovej \u00a0normochr\u00f3mnej an\u00e9mie, a\u017e nesk\u00f4r prech\u00e1dzaj\u00fa \u00a0do mikrocytovej hypochr\u00f3mnej an\u00e9mie (10). Pri posthemoragick\u00fdch \u00a0ak\u00fatnych an\u00e9mi\u00e1ch nie je podstatn\u00fd pokles Hb, ale n\u00e1hla strata objemu \u00a0a\u017e jednej tretiny krvi vedie ku kardi\u00e1lnemu zlyhaniu, ireverzibiln\u00e9mu \u0161oku a kon\u010d\u00ed sa \u00famrt\u00edm pacienta (8).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Z<\/strong><strong>\u00e1<\/strong><strong>ver<\/strong><\/p>\n<p>An\u00e9mie \u00a0ako prejav ochorenia \u00a0s\u00fa \u010dast\u00fdm medic\u00ednskym probl\u00e9mom, ktor\u00fd v\u00fdrazne zhor\u0161uje kvalitu \u017eivota pacientov. Diagnostika ochorenia \u00a0je \u010dasto zlo\u017eit\u00e1, zd\u013ahav\u00e1 a okrem laborat\u00f3rneho n\u00e1lezu sa mus\u00ed bra\u0165 do \u00favahy aj celkov\u00fd klinick\u00fd stav pacienta \u00a0a jeho subjekt\u00edvne \u0165a\u017ekosti. Je preto nutn\u00e9 zd\u00f4razni\u0165 d\u00f4le\u017eitos\u0165 r\u00fdchlej efekt\u00edvnej a racion\u00e1lnej diagnostiky. Nelie\u010den\u00e1 \u00a0\u0165a\u017ek\u00e1 an\u00e9mia m\u00f4\u017ee vies\u0165 a\u017e k smrti \u00a0pacienta. D\u00f4le\u017eit\u00e1 je preto v\u010dasnos\u0165 a komplexnos\u0165 diagnostiky a lie\u010dby, ktor\u00e1 zah\u0155\u0148a spolu- pr\u00e1cu v\u0161etk\u00fdch medic\u00ednskych discipl\u00edn.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Literat\u00fara<\/strong><br \/>\n1. Klener P, et al. Vnit\u0159n\u00ed lek\u00e1rstv\u00ed. 4. prepracovan\u00e9 a doplnen\u00e9 vyd. Praha: Galen; 2011: 427\u2013449, 1174.<br \/>\n2. Bul\u00edkov\u00e1 A, et al. An\u00e9mie v praxi. P\u0159ehledov\u00e9 \u010dl\u00e1nky. Intern\u00ed medic\u00edna. 2011;13(1):31\u201334.<br \/>\n3. Kr\u010d I. Diagnostika nejb\u011b\u017enej\u0161\u00edch typ\u016f an\u00e9mie. Intern\u00ed medic\u00edna pro praxi. 2001;2:88.<br \/>\n4. Penka M, Bul\u00edkov\u00e1 A, et al. Neonkologick\u00e1 hematologie. Praha: Grada; 2009: 248.<br \/>\n5. Trnovec T, Dz\u00farik R. \u0160tandardn\u00e9 diagnostik\u00e9 postupy. Martin: Osveta; 1998: 832.<br \/>\n6. Masopust J, et al. Klinick\u00e1 bioch\u00e9mie. Praha: Karolinum; 1998: 429.<br \/>\n7. Kemma EHJM, Tjalsna H, Willems HL, Swinkels DW. Hepcidin: from discovery to diff erential diagnosis. \u00a0 \u00a0 \u00a0 \u00a0Haematologica. 2008;93:90\u201397.<br \/>\n8. Sakalov\u00e1 A, et al. Klinick\u00e1 hematol\u00f3gia. Martin: Osveta; 2010: 165, 176.<br \/>\n9. Kafkov\u00e1 A. An\u00e9mie \u2013 diagnostika a lie\u010dba. Via practica. 2005;2(3):141\u2013144.<br \/>\n10. Kr\u010d I. \u0158e\u0161en\u00ed anemick\u00e9ho syndr\u00f3mu pro l\u00e9ka\u0159e v praxi. Intern\u00ed medic\u00edna pro praxi. 2002;9:452\u2013456.<br \/>\n11. Erbenov\u00e1 O. An\u00e9mie \u2013 diferenci\u00e1ln\u00ed diagnoza na z\u00e1klade laboratorn\u00edch dat. Practicus. 2007;8:9\u201312.<br \/>\n12. Kubisz P, et al. Hematol\u00f3gia a transfuziol\u00f3gia. Bratislava: Grada; 2006: 323.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>*All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf attachment at the end of the paper. &nbsp; Charakteristika An\u00e9mia je definovan\u00e1 ako chorobn\u00fd stav vznikaj\u00faci zn\u00ed\u017een\u00edm koncentr\u00e1cie hemoglob\u00ednu v 1 litri perif\u00e9rnej krvi pod 130 g u mu\u017eov a pod 120 g u \u017eien. Kone\u010dn\u00fdm d\u00f4sledkom<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"footnotes":""},"categories":[294],"tags":[383,652,633,662,661],"class_list":["post-1074","post","type-post","status-publish","format-standard","hentry","category-hematology","tag-anemia-en","tag-diagnosis","tag-differential-diagnosis","tag-metabolism-of-iron","tag-morphologic-classification","typ_clanku-review-article"],"acf":{"abstrakt":"<p>Anemia is considered a\u00a0disease symptom, not as a separate diagnosis on its own. It belongs among the most frequent medical conditions worldwide affecting almost one third of the population. In the following article, authors point out to causes, differential diagnosis of anemia and the possibilities for quick and effective diagnosis available for laboratories. The aim is differentiation and early diagnosis of most common types of anemia: sideropenic anemia, anemia in chronic disease and pernicious anemia.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Key words:\u00a0<\/strong>anemia, morphologic classification, diagnosis, differential diagnosis, metabolism of iron<\/p>\n","casopis":[{"ID":995,"post_author":"7","post_date":"2016-11-16 12:14:30","post_date_gmt":"2016-11-16 11:14:30","post_content":"<h4><strong>Biochemistry <\/strong><\/h4>\r\n<ul>\r\n \t<li>Biochemical inflammation markers<\/li>\r\n \t<li>Biochemical examinations in liver diseases<\/li>\r\n \t<li>Biochemical diagnosis in diseases of GIT<\/li>\r\n \t<li>Hypoglycemia<\/li>\r\n \t<li>Urolithiasis as a result of metabolic diseases<\/li>\r\n \t<li>Indication and application of tumor markers in clinical practice<\/li>\r\n \t<li>Monoclonal gammopathies \u2013 laboratory examinations in diagnosis and monitoring<\/li>\r\n \t<li>Hormones in diagnosis of reproductive function disorders<\/li>\r\n \t<li>Cerebrospinal fluid diagnosis of diseases affecting the nervous system<\/li>\r\n \t<li>Determining trace elements in blood serum<\/li>\r\n<\/ul>\r\n<h4><strong>Genetics<\/strong><\/h4>\r\n<ul>\r\n \t<li>Assessing the therapeutic response in patients with chronic myelocyte leukemia treated with tyrosine kinase inhibitors<\/li>\r\n \t<li>Hormones in diagnosis of reproductive functions\u2019 disorders<\/li>\r\n<\/ul>\r\n<h4><strong>Hematology <\/strong><\/h4>\r\n<ul>\r\n \t<li>Anemias \u2013 laboratory diagnosis of the most frequently prevalent types of anemia<\/li>\r\n \t<li>Laboratory and hematological technical equipment<\/li>\r\n<\/ul>\r\n<h4><strong>Immunology <\/strong><\/h4>\r\n<ul>\r\n \t<li>Paraneoplastic neurological syndromes and in vitro diagnosis of onconeural antibodies<\/li>\r\n<\/ul>","post_title":"newslab","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"newslab","to_ping":"","pinged":"","post_modified":"2017-08-16 21:40:20","post_modified_gmt":"2017-08-16 19:40:20","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.newslab.sk\/casopis\/newslab\/","menu_order":0,"post_type":"casopis","post_mime_type":"","comment_count":"0","filter":"raw"}],"strana":"6","upload_clanok":{"ID":1075,"id":1075,"title":"anemie_bednarova","filename":"Anemie_Bednarova.pdf","filesize":160448,"url":"https:\/\/www.newslab.sk\/wp-content\/uploads\/2016\/12\/Anemie_Bednarova.pdf","link":"https:\/\/www.newslab.sk\/en\/anemias-laboratory-diagnosis-of-the-most-common-types-of-anemia\/anemie_bednarova\/","alt":"","author":"7","description":"","caption":"","name":"anemie_bednarova","status":"inherit","uploaded_to":1074,"date":"2016-12-07 21:13:28","modified":"2016-12-07 21:13:28","menu_order":0,"mime_type":"application\/pdf","type":"application","subtype":"pdf","icon":"https:\/\/www.newslab.sk\/wp-includes\/images\/media\/document.png"}},"_links":{"self":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1074","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/comments?post=1074"}],"version-history":[{"count":0,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1074\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/media?parent=1074"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/categories?post=1074"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/tags?post=1074"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}