Anemia: Difference between revisions

Revision as of 13:40, 1 December 2021

Differential Diagnosis

Microcytic anemia (MCV <80)

Iron-deficiency anemia
Thalassemia
Anemia of chronic inflammation (ferritin < 100 and Fe Sat < 20%)
Lead poisoning
Sideroblastic anemia

Normocytic anemia (MCV 80-100)

Elevated reticulocytes (normal marrow response)
- Hemolytic anemia
  - Intrinsic RBC defect
    - Hemoglobinopathy
    - Enzymopathy: G6PD deficiency
    - Membrane-cytoskeletal defects
      - Hereditary spherocytosis
      - Hereditary elliptocytosis
    - Paroxysmal nocturnal hemoglobinuria
  - Extracorpuscular
    - Microangiopathic hemolytic anemia
    - Drugs and toxins: oxygen, nitrates, chlorates, methylene blue, dapsone, cisplatin, arsine, copper, lead
    - Infections: malaria, HUS, Clostridium perfringens
    - Autoimmune hemolytic anemia
      - Cold and warm AIHA
Low or inappropriately normal reticulocytes (poor marrow response or low erythropoietin)
- Chronic kidney disease

Macrocytic anemia (MCV >100)

Megaloblastic
Non-megaloblastic

Investigations

CBC with differential
- MCHC increased in HS and Hb SS
- MCH decreased in hypochromic anemias
- RDW increased in iron deficiency, reticulocytosis, blood transfusion
Reticulocyte count (normally 1-2%)
Peripheral blood film
Ferritin, transferrin saturation
Vitamin B12
SPEP, and UPEP or serum free light chains

@@ Line 4: / Line 4: @@
 * [[Iron-deficiency anemia]]
-* Thalassemia
+* [[Thalassemia]]
-* Anemia of chronic inflammation (ferritin &lt; 100 and Fe Sat &lt; 20%)
+* [[Anemia of chronic inflammation]] (ferritin &lt; 100 and Fe Sat &lt; 20%)
-* Lead poisoning
+* [[Lead poisoning]]
-* Sideroblastic anemia
+* [[Sideroblastic anemia]]
 === Normocytic anemia (MCV 80-100) ===
 * Elevated reticulocytes (normal marrow response)
-** Hemolytic anemia
+** [[Hemolytic anemia]]
 *** Intrinsic RBC defect
-**** Hemoglobinopathy
+**** [[Hemoglobinopathy]]
-**** Enzymopathy: G6PD deficiency
+**** Enzymopathy: [[G6PD deficiency]]
 **** Membrane-cytoskeletal defects
-***** Hereditary spherocytosis
+***** [[Hereditary spherocytosis]]
-***** Hereditary elliptocytosis
+***** [[Hereditary elliptocytosis]]
 **** [[Paroxysmal nocturnal hemoglobinuria]]
 *** Extracorpuscular
 **** [[Microangiopathic hemolytic anemia]]
-**** Drugs and toxins: oxygen, nitrates, chlorates, methylene blue, dapsone, cisplatin, arsine, copper, lead
+**** Drugs and toxins: oxygen, nitrates, chlorates, [[methylene blue]], [[dapsone]], [[cisplatin]], arsine, copper, lead
-**** Infections: malaria, HUS, ''C. perfringens'' sepsis
+**** Infections: [[malaria]], [[HUS]], [[Clostridium perfringens]]
 **** [[Autoimmune hemolytic anemia]]
 ***** Cold and warm AIHA
 * Low or inappropriately normal reticulocytes (poor marrow response or low erythropoietin)
-** Chronic kidney disease
+** [[Chronic kidney disease]]
 === Macrocytic anemia (MCV &gt;100) ===
-* Megaloblastic
+* [[Megaloblastic anemia|Megaloblastic]]
 * Non-megaloblastic
 == Investigations ==
+* CBC with differential
+** MCHC increased in HS and Hb SS
-* Bloodwork
+** MCH decreased in hypochromic anemias
-** CBC with differential
-*** MCHC increased in HS and Hb SS
+** RDW increased in iron deficiency, reticulocytosis, blood transfusion
+* Reticulocyte count (normally 1-2%)
-*** MCH decreased in hypochromic anemias
+* Peripheral blood film
-*** RDQ increased in IDA, reticulocytosis, blood transfusion
+* Ferritin, transferrin saturation
-** Reticulocyte count (normally 1-2%)
+* Vitamin B12
-** Peripheral blood film
+* SPEP, and UPEP or serum free light chains
-** Ferritin, transferrin saturation
-** Vitamin B12
-** SPEP, and UPEP or serum free light chains
-* Imaging
-* Other
 [[Category:Hematology]]
 [[Category:Investigation]]