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Overview of Anaemia

Definition Red cell indices

↓ Hb concentration of blood RBC count
Reference to healthy individuals Hb
Age HCT/ PCT (Haematocrit/ Packed cell volume)
Sex MCV (Mean cell volume)
Physiological state MCH (Mean cell haemoglobin)
Environment (altitude) MCHC (Mean cell haemoglobin con centration)
RDW (Red cell distribution width)
Normal values of Red Cell Indices Reticulocyte count
Male Female
Hb (g/dl) 13.0 - 18.0 12.0 - 16.5 History Taking
Hematocrit (HCT) 0.40 - 0.54 0.37 - 0.47 Main symptoms of anaemia
Packed cell volume (PCV) Lethargy
RBC (x૚૙૚૛/L) 4.5 - 6.5 4.0 - 5.5 Lassitude
MCV (fl) 76 - 96 76 - 96 Malaise
MCH (pg) 27 - 33 27 - 33 Fatigue
MCHC (g/dL) 32 - 36 32 - 36 Tiredness
Family history
Classification of Anaemia Dietary history
Pathophysiol ogy/ Aetiology Vegetarian – Megaloblastic anaemia (B12, Folate deficiency)
Blood loss ↑ Destruction ↓ Production Drug – Hemolytic anaemia (Hemolysis drugs)
Jaundice Complications
Morphology (based on Full Blood Picture (FBP)) Congestive cardiac failure (CCF)
Normocytic Microcytic Macrocytic
normochromic hypochromic Diagnostic approach to anaemia
MCV normal MCV ↓ MCV ↑
MCH normal MCH ↓ MCH ↑
Causes
Chronic inflammatory Iron deficiency Megaloblastic anaemia
disease (B12, Folate deficiency)
Malignancy Thalassaemia Non-megaloblastic
Renal/ endocrine Anaemia of chronic anaemia
diseases diseases (alcohol, liver disease,
Blood loss Sideroblastic anaemia myelodysplasia,
Haemolysis Lead poisoning aplastic anaemia, acute
blood loss, acute
haemolysis)
Lab investigations
FBP FBP FBP
Reticulocyte count Serum ferritin/ Reticulocyte count
Transferrin saturation/
Se Iron/ TIBC/ Soluble
transferring receptor
Biochemi cal tests Hb electrophoresis Serum B12, FBC Folate
Bone marrow exam Marrow iron stores LFT/ TFT
Bone marrow exam
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Microcytic Hypochromic Anaemia

Lead poisoning

Normocytic Normochromic