ANEMIA (RBC)

Reticulocyte Count and Smear

Hemolysis

Microangiopathic
Spherocytosis
Eliptocytosis

Enzyme Deficiency

G6P Dehyd
Pyruvate Dehyd

Hemoglobinopathy

Sickle Cell
HbSC Disease
Other Hemoglobins

Bone Marrow

Chronic Infection

Renal Failure

Liver Disease

Endocrinopathy

Malignancy

Malignancy

Infiltration
Primary

Aplastic Anemia

RDW

Serum Fe

Ferritin

Transfer Sat

TIBC

(FEP)

RDW

Serum Fe ,

Ferritin

Trans St

TIBC

FEP

RDW N

Serum Fe

Ferritin

Trans Sat N,

TIBC N,

FEP

Evidence for Hemolysis

Schizocytes
Target and Helmet Cells
Hyperbilirubinemia

Haptoglobin

Hemopexin

Malignant HTN
Eclampsia
Hemangioma
Renal Graft Reject
Microangiopathic

-HUS / TTP

-DIC

-HUS / TTP

-DIC

RBC B12 and Folate

Malabsorption
Malnourishment
Chemotherapy
Anticonvulsants
OCPs
Triampterent
Bactrim®
Cochicine

Myelodysplasia

Cold Agglutinine
Hyperglycemia
Leukocutosis(CLL)

RDW N

Serum Fe N

Ferritum N,

Trans Sat N

TIBC N

FEP N

RDW N,

Serum Fe N,

Ferritin N,

Trans Sat N,

TIBC N,

FEP N

Alchoholism
Hypothyroidism
Liver Disease

Bleeding
Nutrition

Long term debilitated
Poor nutrition
Decreased Epo level

Hb Electrophoresis
Family History
Difficult to prove

Heriditary
Acquired (eg drugs)
? Myelodysplasia
Bone Marrow Bx

Ring Sideroblasts
Iron Stores

Ring Sideroblasts
Iron Stores

MICROCYTOSIS
MCV < 83 pl

NORMOCYTOSIS
MCV 83-98 pl

MACROCYTOSIS
MCV > 98 pl

Normal

Abnormal

Fe Defieiency

Chronic Disease

Thalassemia Trait

Sideroblastic

YES

NO

Extravascular

Splenomegaly
Immune Hemolysis

-Warm Antibody
Neoplasm
Vasculitis
Drugs
α M-Dopa
Quinidine
Penicillin

-Cold Antibody
Idiopatghic
Lymphoma
Mycoplasma
Mononucleosis

Intravascular

Haptoglobin

Hemopexin

Malignant HTN
Eclampsia
Hemangioma
Renal Graft Reject
Microangiopathic

-HUS / TTP

-DIC

-HUS / TTP

-DIC

Megaloblastic

Non Megaloblastic

Artifact

END