Examination of Anaemia - Flowchart

Examination of Anaemia - Flowchart

Examination of Anaemia - Flowchart Examination of Anaemia Examination of Anaemia

«Flowchart»

Anaemia

Anaemia

Anaemia

Normocytic anaemia

Normocytic anaemia

Normocytic anaemia

Microcytic anaemia

Microcytic anaemia

Microcytic anaemia

Macrocytic anaemia

Macrocytic anaemia

Macrocytic anaemia

MCV

MCV

MCV

<80

<80

< <80 <

80-100

80-100

80-100

>100

>100

>100

Iron deficiency

Iron deficiency

Iron deficiency

Chronic disease or increased ESR

Chronic disease or increased ESR

Chronic disease or increased ESR

Yes

Yes

Yes

No

No

No

Endoscopy

Endoscopy

Endoscopy

Female

Female

Female

Yes

Yes

Yes

No

No

No

Iron therapy

Iron therapy

Iron therapy

End

End

End

Heavy menstruation

Heavy menstruation

Heavy menstruation

Yes

Yes

Yes

No

No

No

Secondary anaemia
Check at least creatine level

Secondary anaemia
Check at least creatine level

Secondary anaemia
Check at least creatine level

Unknown aetiology?

Unknown aetiology?

Unknown aetiology?

Bone marrow examination (Always, if abnormalities in other cell lines)

Bone marrow examination (Always, if abnormalities in other cell lines)

Bone marrow examination (Always, if abnormalities in other cell lines)

Chronic disease or increased ESR

Chronic disease or increased ESR

Chronic disease or increased ESR

Yes

Yes

Yes

No

No

No

TfR

TfR

TfR

Normal

Normal

Normal

> reference value

> reference value

> reference value

Ferritin

Ferritin

Ferritin

≥30

≥30

≥ >=30

<30

<30

< <30 <

Megaloblastic anaemia

Megaloblastic anaemia

Megaloblastic anaemia

Vitamin B₁₂ bound to transcobalamin II, Erythrocyte folate

Vitamin B₁₂ bound to transcobalamin II, Erythrocyte folate

Vitamin B₁₂ bound to transcobalamin II, Erythrocyte folate

₁₂

Normal

Normal

Normal

Decreased

Decreased

Decreased

Hemolytic anaemia

Hemolytic anaemia

Hemolytic anaemia

GT, ALT
TSH, free T₄

GT, ALT
TSH, free T₄

GT, ALT
TSH, free T₄

₄

Reticulocyte count

Reticulocyte count

Reticulocyte count

>2%

>2%

>2%

≤2%

≤2%

<=2% <

Liver disease?
Alcohol disease?
Hypothyroidism?

Liver disease?
Alcohol disease?
Hypothyroidism?

Liver disease?
Alcohol disease?
Hypothyroidism?

Yes

Yes

Yes

No

No

No