Overall Approach to Anemia - Differential Diagnosis Algorithm
Blood Loss
• Acute Bleed - Normocytic / Normochromic RBCs on Smear
• Chronic Bleed - Any combination of: Decreased Reticulocytes, MCV, MCH, MCHC, Serum Iron, Ferritin, Increased TIBC, Hypochromic RBCs
Decreased RBC Production - Normal / Decreased Reticulocytes
• Iron Deficiency
• B12/Folate Deficiency
• Aplastic Anemia
• Anemia of Chronic Disease
• Marrow Infiltration
Increased RBC Destruction - Increased Reticulocytes, Increased Unconjugated Bilirubin, Spherocytes on Smear
- Congenital
• Hemoglobinopathy
• Thalassemia
• RBC Membrane Disorder
• RBC Metabolism Disorder
- Acquired
• Immune
• Non-lmmune
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