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Hematopoietic System
Neither quantitative nor qualitative disorders necessarily imply impairment. Rather, impairment depends on the severity of the defect and the mode of clinical expression.Within this section, general reference is made to symptomatology and to limitations of the patient’s daily activities. The physician should determine whether these fit into one of the following categories:
(a) NONE there are no complaints or evidence of disease, and the usual activities of daily living can be performed;
(b) MINIMAL some signs or symptoms of disease are present, and there is some difficulty in performing the usual activities of daily living;
(c) MODERATE signs and symptoms of disease are present, and difficulty is experienced in performing the usual activities of daily living that now require varying amount of assistance from others; or
(d) MARKED signs and symptoms of disease are present, and assistance is needed in performing most to all activities of daily living.
Anemia Persistent refractory anemia may cause impairment, regardless of etiology; the degree of impairment is related to the severity of the anemia and the need for transfusions.Under the best of circumstances, with normal survival of the transfused red cells, the beneficial effects of transfusions last 6—8 weeks. In patients with hemolytic anemias due to serum factors, and in some patients who have been transfused many times, the survival of transfused cells becomes shortened and transfusions must be repeated at shorter intervals of 1—5 weeks. As hemolysis becomes more severe, impairment increases.(Mild anemia with a hemoglobin level of about l0gm/100ml is associated with little impairment in a patient who has a normal cardiovascular system)
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