Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 146 (4), 443-51

Laboratory Evaluation of Anemia

Laboratory Evaluation of Anemia

R O Wallerstein Jr. West J Med.

Abstract

The laboratory evaluation of anemia begins with a complete blood count and reticulocyte count. The anemia is then categorized as microcytic, macrocytic or normocytic, with or without reticulocytosis. Examination of the peripheral smear and a small number of specific tests confirm the diagnosis. The serum iron level, total iron-binding capacity, serum ferritin level and hemoglobin electrophoresis generally separate the microcytic anemias. The erythrocyte size-distribution width may be particularly helpful in distinguishing iron deficiency from thalassemia minor. Significant changes have occurred in the laboratory evaluation of macrocytic anemia, and a new syndrome of nitrous oxide-induced megaloblastosis and neurologic dysfunction has been recognized. A suggested approach to the hemolytic anemias includes using the micro-Coombs' test and ektacytometry. Finally, a number of causes have been identified for normocytic anemia without reticulocytosis, including normocytic megaloblastic anemia and the acquired immunodeficiency syndrome.

Similar articles

  • Evaluation of Anemia in Children
    J Janus et al. Am Fam Physician 81 (12), 1462-71. PMID 20540485. - Review
    Anemia is defined as a hemoglobin level of less than the 5th percentile for age. Causes vary by age. Most children with anemia are asymptomatic, and the condition is dete …
  • Red Blood Cell Morphology
    J Ford. Int J Lab Hematol 35 (3), 351-7. PMID 23480230. - Review
    The foundation of laboratory hematologic diagnosis is the complete blood count and review of the peripheral smear. In patients with anemia, the peripheral smear permits i …
  • Diagnosis of Anemia. Clues to Greater Precision
    DJ Christensen. Postgrad Med 73 (1), 293-7, 300. PMID 6848993.
    Typical features on the blood smear suggest the diagnosis in some types of anemia, such as the common microcytic anemias, megaloblastic anemias, and certain hemolytic ane …
  • Microcytic Anemia
    JW Shine. Am Fam Physician 55 (7), 2455-62. PMID 9166144.
    Because anemia is a condition rather than a disease, an underlying cause must be determined when anemia is identified. Microcytic anemia is a common category of anemia. I …
  • Diagnostic Clues to Megaloblastic Anaemia Without Macrocytosis
    CW Chan et al. Int J Lab Hematol 29 (3), 163-71. PMID 17474892.
    Masking of the macrocytic expression of megaloblastic anaemia (MA) by coexisting thalassaemia, iron deficiency and chronic illness has been widely reported. We described …
See all similar articles

Cited by 3 PubMed Central articles

  • Computerized Morphometric Analysis of Eryptosis
    SS Jacob et al. Front Physiol 10, 1230. PMID 31649550.
    Eryptosis is the suicidal destruction-process of erythrocytes, much like apoptosis of nucleated cells, in the course of which the stressed red cell undergoes cell-shrinka …
  • Evaluation of Macrocytosis in Routine Hemograms
    P Veda. Indian J Hematol Blood Transfus 29 (1), 26-30. PMID 24426329.
    Macrocytosis, a condition in which erythrocytes are larger than normal manifests as an increase in mean corpuscular volume (MCV) more than 100 fl. The aim of this study w …
  • Antiretroviral Treatment Reverses HIV-associated Anemia in Rural Tanzania
    A Johannessen et al. BMC Infect Dis 11, 190. PMID 21745396.
    Most patients had anemia at enrollment, of whom nearly 40% had microcytosis and hypochromia suggestive of iron deficiency. The mean hemoglobin increased significantly in …

References

    1. J Pediatr. 1975 Apr;86(4):539-41 - PubMed
    1. West J Med. 1978 Apr;128(4):294-304 - PubMed
    1. Lancet. 1978 Aug 12;2(8085):339-42 - PubMed
    1. Blood. 1979 Jan;53(1):109-15 - PubMed
    1. Lancet. 1978 Dec 9;2(8102):1227-30 - PubMed
Feedback