Classification of anemia

1
Classification of anemia

• Functional classification
• Hypoproliferative destruction (infective
  hematopoiesis).
• Clinical classification
• Causes of anemia (blood loss, IDA, hemolysis).
• Quantitative classification
• Hematocrit
• Hemoglobin
• Blood cell indices (MCV, MCH, MCHC).
• Reticulocytes count.

2
Red cell indices

• MCV (mean corpuscular volume)
• The average volume of RBC
• Hct
• ? 10 (fl)
• RBC count (m/µL)
• e.g. Hct 40
• RBC5.0 (m /µL)
• MCV 40/5.0 ? 10 80 fl
• NR 80-96 fl

3

• MCH (mean corpuscular hemoglobin)
• The average content of Hb in average RBC.
• It is directly proportional to the amount of Hb
  and RBC size.

Hb
? 10 (pg)
MCH
RBC count (m/µL)
e.g. Hb 14 g/dl RBC 4 (m/µL)
MCH 14/4 ? 10 35 pg NR 27-32 pg
4

• MCHC (mean corpuscular hemoglobin concentration)
• Express the average concentration of hemoglobin
  per unit volume of RBC.
• It defined as the ratio of the weight of
  hemoglobin to volume of RBC.

Hb (g/dl)
? 100 ()
MCHC
Hct ()
e.g. Hb 14 g/dl Hct 45 MCHC 14/45 ?
100 31 NR 32-36
5
Symptoms of Anemia
Normal or High
Hemoglobin/Hematocrit
Check other Causes of symptoms e.g. Cardiac
Pulmonary
Low RBC indices
MCV gt 98
MCV80-96
MCV lt 80 MCHC lt 32
History of acute blood loss Auto immune Hemolytic
anemia Anemia of chronic Diseases Anemia of
infection
B12 and folate levels
Serum iron and Total Iron binding capacity of
Ferritin
Normal Hb electrophoresis for Thala.
Low Iron IDA, chronic diseases, Renal diseases
High Iron BM exam For Sideroblastic anemia
Low B12 PA, GI problems Severe malnutrition.
Low folate Folate malnutrition GI problems Liver
disease
High or Normal MPD Liver Disease
6
Normal red cell morphology
7
Hypochromic Hyperchromic
Macrocytic Microcytic
8
IDA
Stomatocytes
Target cells
Sickle cells
Poikiolocytosis
Acanthocytes
Spherocytes
Nucleated RBC
Ovalocyte