Blood tests include mean cell volume mcv and red blood cell distribution width rdw. Laboratory diagnosis of hemoglobinopathies and thalassemia. For example, in patients with chronic illness, iron studies are obtained to evaluate for acd, with. The anemia is then categorized as microcytic, macrocytic or normocytic, with or without reticulocytosis.
Suggested laboratory test ordering guideline to assist clinicians and laboratories in the diagnosis of anemia in adults keywords. Anemia is defined as a decrease in the concentration of the hemoglobin depending upon the age and the sex of the patient. The normal reticulocyte count in a patient with a normal hb and hct is about 1%. Anemia due to hemolysis or bleeding is characterized by the presence of a reticulocytosis. A low serum ferritin level is diagnostic of an irondepleted state. Department of health health systems quality assurance inspections and investigations office subject. The diagnosis of iron deficiency anaemia in hospital patients with chronic infections and inflammation presents a challenge. Clinical diagnosis of anemia is based on history, physical examination, signs, symptoms, and laboratory test results. Many diseases, conditions, and other factors can cause this to happen. If the blood levels of ferritin are low it indicates low iron stores in the body and helps detect iron deficiency anemia.
Hemolytic anemia is defined by the premature destruction of red blood cells, and can be chronic or lifethreatening. The hallmarks of scd are vasoocclusive phenomena and hemolytic anemia. Anemia is a condition that occurs when the amount of hemoglobin in a persons blood drops below normal. See what can cause your body to make too few red blood cells. Further testing is performed which reveals a negative direct antiglobulin test, a. Anemia healthy changes national heart, lung, and blood. Ferritin stores ferritin is a protein that stores iron. Laboratory diagnosis of anemia wiley online library. Diagnosis and management of iron deficiency anaemia.
Iron deficiency is thought to be the most common cause of anaemia globally, but. Our ability to reliably diagnose, and therefore exclude, a variety of inherited or acquired diseases with similar phenotypes has improved markedly. Anemia classification on the basis of rbc morphology. Approach to diagnosis of anemia classification of anaemia distinct features of each type of. Fiftyfive studies included the results of laboratory tests and histologic.
Skin pigmentation in the perioral region and over the knuckles is suggestive of megaloblastic anaemia. With iron deficiency anemia, red blood cells are smaller and paler in color than normal. Autoimmune hemolytic anemia autoimmune hemolytic anemia aiha is mediated by autoantibodies and further subdivided according to their maximal binding temperature. Diagnosis and management of anaemia of chronic disease. Pathophysiology and differential diagnosis of anaemia. Recently laboratory tests such as the reticulocyte haemoglobin content, which are independent of infection and inflammation, have become available for routine diagnostic use. Laboratory tests used in anemia diagnosis gure has been modi ed. Anaemia is a condition in which the number of red blood cells and consequently their. C 6, 7 all pregnant women should be screened for iron deficiency anemia. Guideline for the laboratory diagnosis of functional iron. Computerized searches of the medline database yielded 1,179 potentially relevant citations.
Classification of the varieties of hemolytic anemia is based upon whether hemolysis is due to inherent defects within the erythrocyte or to extracellular factors. A nemia is defined as reduction in number of red blood cells or hemoglobin, resulting in lower oxygen carrying capacity. Serum folate assays showed great variation between methods, partly due to limitations. Evaluation of anemia merck manuals professional edition. Haemoglobin concentrations for the diagnosis of anaemia.
Measurement of the serum ferritin level is the most accurate test to diagnose iron deficiency anemia. This is the percentage of your blood volume made up by red blood cells. Laboratory diagnosis oflaboratory diagnosis of thalassemia. To determine the diagnostic values of laboratory tests used in the diagnosis of irondeficiency anemia, the authors conducted a systematic overview of the relevant literature. Get a printable copy pdf file of the complete article 2. Symptom checklist pdf this is useful to print, read and fill in.
It should be part of the differential diagnosis for any normocytic or macrocytic anemia. To diagnose iron deficiency anemia, your doctor may run tests to look for. Diagnosis of pernicious anaemia pernicious anaemia society. Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Iron deficiency anemia pathogenesis and lab diagnosis. Hemolysis may occur intravascularly, extravascularly in the reticuloendothelial system, or both. Reticulocyte count ability of marrow to respond to anemia. The reticulocyte count is used to assess the appropriateness of the bone marrow response to anemia. Practice guideline, anemia screening, anemia, clac guideline. Diagnosis to diagnose anemia, your doctor is likely to ask you about your medical and family history, perform a physical exam, and run the following tests. Iron deficiency anemia diagnosis and treatment mayo clinic.
Iron deficiency anemia pathogenesis and lab diagnosis 1. Laboratory diagnosis of irondeficiency anemia springerlink. The diagnosis of anemia depends on lab investigations and a brief approach to anemia. Careful questioning of the patient may reveal contributing factors such as diet, medications, occupational hazards, and bleeding history. Algorithm depicting diagnostic approach to anaemia. Laboratory diagnosis of hemoglobinopathies and thalassemia medical director, hematopathology and rbc laboratory. An efficient diagnostic plan is important because time from diagnosis to treatment is related to outcome regardless of the therapeutic option chosen.
Iron deficiency anemia pathophysiology and lab diagnosis dr. C 4, 11, 14 all adult men and postmenopausal women with iron deficiency anemia should be screened for gastrointestinal malignancy. Anemia occurs when your body makes too few rbcs, destroys too many rbcs, or loses too many rbcs. Haemoglobin concentrations for the diagnosis of anaemia and. To determine the diagnostic values of laboratory tests used in the diagnosis of ironde ficiency anemia, the authors conducted a. Learning objectives at the end of this briefing, you should know clinical presentation of anemia. Anaemia is usually mild to moderate hb levels rarely below 80gl with a low reticulocyte count.
Regardless of the specific algorithm followed in evaluating anemia, it is essential that easily remediable causes such as nutritional deficiencies, hemolysis, and anemia of renal insufficiency are identified early and treated appropri. Anemia is defined as a hemoglobin hb level anaemia is a common nutritional deficiency disorder and global public health problem which affects both developing and developed countries with major consequences for. Blood is added to reducing agent sodium dithionate and lysing agent that release hemoglobin from rbc. A decrease in hemoglobin is often associated with a decrease in the number of red blood cells rbcs and hematocrit. Patients generally present with symptoms of anaemia. Hemoglobin is contained within rbcs and is necessary to transport and deliver oxygen from the lungs to the rest of the body. Red cell indices are critical to diagnosis hypochromic microcytic anemia mcv mean corpuscular volume or size of the cell is key. Many types of anemia exist, such as irondeficiency. Immune hemolytic anemia is classified as autoimmune, alloimmune, or druginduced, based on the antigen that stimulates antibody or complementmediated destruction of red blood cells. Diagnosis and management of aplastic anemia hematology. Initially, nearly all anaemias are normocytic only with time do they become microcytic or macrocytic. Laboratory testing initial testing cbc with peripheral smear.
Normocytic anaemia is a result either of red cell destruction or loss haemorrhage or haemolysis or of deficient red cell production aplasia, anaemia of chronic disease. It is an important public health problem in australia, with the world health organization who estimating that 8% of preschool children, 12% of pregnant women and 15% of nonpregnant women of reproductive age in australia have anaemia, with ida a major cause. Specific physiologic needs vary with a persons age, gender, residential elevation above sea level altitude, smoking behaviour, and different stages of pregnancy. Laboratory diagnosis oflaboratory diagnosis of thalassemia yneed to start with patients individual history and familyyy history. Confirmation of diagnosis in cases in which the disease is clinically suspected is made. Thus, even mild, asymptomatic anemia should be investigated so that the primary problem can be diagnosed and treated. The laboratory evaluation of anemia begins with a complete blood count and reticulocyte count. When something goes wrong in your blood, it can affect your health and quality of life.
Examination of the peripheral smear and a small number of specific tests confirm the diagnosis. The approach outlined here is based on the abovementioned classification, clinical scenario and full blood count fbc findings. Morphology classification microcytic mcv anemia, lead poisoning normocytic mcv 80100 cu microns acute blood loss, chronic disease, hypersplenism, bone marrow failure, hemolysis macrocytic megaloblastic anemia, hemolysis with reticulocytosis. Diagnosis diagnosis of iron deficiency anaemia in hospital. Anemia types and characteristic finding classification of. Anaemia is one of the most common conditions encountered in clinical practice. Sickle cell trait is a benign carrier condition characterized by heterozygosity for the sickle hemoglobin mutation. Introduction anemia is functionally defined as an insufficient rbc mass to adequately deliver oxygen to peripheral tissues. Laboratory diagnosis of iron deficiency anemia ida anemia is the condition of decrease in number of circulating red blood cells and hence hemoglobin below a normal range for age and sex of the individual, resulting in decreased oxygen supply to tissues.
To read our extended information on the diagnosis of pernicious anaemia, please login or become a member. Laboratory evaluation of anemia pubmed central pmc. Examination of the peripheral smear and a small number of specific tests. Screening and diagnosis of sickle cell disorders are discussed here. All types of anemia with full anemia definition chart and. History and physical examination are followed by laboratory testing with a. Decreased solubility of deoxygenated hgb s form the basis for this test. Who definition for anemia is hemoglobin less than gmdl for men and less than 12gmdl for women.
1151 963 1560 250 703 423 681 1168 1115 1045 23 534 698 14 918 1277 322 494 698 1369 692 1119 1430 438 740 1492 255 154 511 168 666 1307 694 1284 932 481 1376 1222