The topic of this presentation is Investigations of Anaemia and We will also discuss the test of Anaemia .It is made by Dr.Rifat Qureishi , Thankyou

1. Ivestigations
of Anaemia
By Dr. Rifat Qureishi Usmani
Asso. Prof. Pathology

2. Tests for Anaemia
•A) Haemoglobin Estimation
•B) Peripheral Blood Film Examination
1.Variation in size (Anisocytosis)
Anisocytosis may be due to the presence
of cells larger than normal (macrocytosis)
or cells smaller than normal (microcytosis).
Sometimes both microcytosis and
macrocytosis are present (dimorphic).

3. …i) Macrocytes-megaloblastic anaemia
aplastic anaemia
dyserythropoietic anaemias
chronic liver disease
ii) Microcytes-iron deficiency anaemia,
thalassaemia .
spherocytosis.
haemolytic anaemia.

4. 2.Variation in shape (Poikilocytosis)
Causes: Megaloblastic anaemia
Iron deficiency anaemia
Thalassaemia
Myelosclerosis

5. 3.Inadequate haemoglobin formation
(Hypochromasia)
Increased central pallor is referred to as hypochromasia.
e.g.: Iron deficiency anaemia
Chronic infections
Thalassaemia
Sideroblastic anaemia
Unusually deep pink staining of the red cells due to increased
haemoglobin
concentration is termed hyperchromasia and may be found in:
megaloblastic anaemia
spherocytosis
neonatal blood.

6. Tests for Anaemia {b}
(Peripheral blood film examination)
...4.Compensatory erythropoiesis
a. Polychromasia is defined as the red cells having more
than
one type of color .
b. Erythroblastaemia is the presence of nucleated red
cells in
the peripheral blood film.Haemolytic disease of the
newborn, other haemolytic disorders and in extramedullary
erythropoiesis.Erythroblastaemia may also occur after
splenectomy.

7. c. Punctate basophilia or basophilic stippling is diffuse and
uniform basophilic granularity in the cell.
Seen in: Aplastic Anaemia
Thalassaemia
Myelodysplasia Infections
Lead Poisoning.
d. Howell-Jolly bodies are purple nuclear remnants, usually
found singly, and are larger than basophilic stippling.
Seen in :Megaloblastic Anaemia
After Splenectomy.

8. Tests for Anaemia
•C) RED CELL INDICES
•1.In iron deficiency and thalassaemia, MCV, MCH and
MCHC
•are reduced.
•2. In anaemia due to acute blood loss and haemolytic
anaemias, MCV, MCH and MCHC are all within normal
limits.
•3. In megaloblastic anaemias, MCV is raised.

9. •1. Mean corpuscular volume (MCV)
PCV(%)x10
RBC(millions/mm³)
•The normal value is 85 ± 8 fl (77-93 fl).
•Mean corpuscular haemoglobin (MCH)
Hb(g/dL)x10
RBC(millions/mm³)
•The normal range is 29.5 ± 2.5 pg (27-32 pg).

10. •Mean corpuscular haemoglobin concentration
(MCHC)
Hb(g/dL)x100
PCV(%)
•The normal value is 32.5 ± 2.5 g/dl (30-35 g/dl).

11. Tests for Anaemia
•D. LEUCOCYTE AND PLATELET COUNT
•E.RETICULOCYTE COUNT-Reticulocyte count (normal 0.5-
2.5%) is done in each case of anaemia to assess the marrow
erythropoietic activity. In acute haemorrhage and
in haemolysis, the reticulocyte response is indicative of
impaired marrow function.
•F. ERYTHROCYTE SEDIMENTATION RATE-The ESR is a
non-specific test used as a screening test for anaemia. It
usually gives a clue to the underlying organic disease but
anaemia itself may also cause rise in the ESR.

12. Tests for Anaemia
• G.BONE MARROW EXAMINATION-Bone marrow
aspiration is done in cases where the cause for anaemia is
not obvious.

13. Thankyou
By Dr. Rifat Qureishi
Assoc. Prof. Pathology
M.D.