Causes of Anemia in Cirrhosis - Differential Diagnosis Framework LOW RETIC INDEX - ↓ PRODUCTION • Vitamin B12 deficiency, Folate deficiency, Alcohol related, Iron deficiency, Inflammation NORMAL / HIGH RETIC INDEX: • Blood Loss: Variceal bleed, esophageal, gastric, rectal, Peptic ulcer disease, Hemorrhoidal bleed, Gastric antral vascular ectasia, Hematomas, Epistaxis • Sequestration: Look for splenomegaly, Thrombocytopenia suggestive • Destruction: Zieve's syndrome, Spur cell anemia, Autoimmune hemolytic anemia, Hemolysis related to Wilson's disease, DIC-low factor 8 Dr. Ann Marie Kumfer @AnnKumfer #Anemia #Cirrhosis #Differential #Diagnosis #Hepatology
