Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV
Microcytic (MCV < 80) "TAILS":
• Thalassemia
• ACD (inflammation)
• Iron deficiency
• Lead poisoning
• Sideroblastic anemia
Normocytic (MCV 80-100):
• Non-hemolytic: ACD, Aplastic anemia, CKD
• Hemolytic:
- Intrinsic: H. Spherocytosis, G6PD, PK, HbC, HbSS, PNH
- Extrinsic: Autoimmune, MAHA, Macroangiopathic, Infections
Macrocytic (MCV > 100):
• Megaloblastic: Folate deficiency, B12 deficiency, Orotic aciduria, Drugs (e.g., hydroxyurea, antifolate)
• Non-megaloblastic: Liver disease, Alcoholism, Hypothyroidism, Reticulocytosis, MDS
Matthew Ho, MD PhD @MatthewHoMD
#Anemia #MCV #Algorithm #Differential #Diagnosis #hematology
