2. The causes of anemia fall into three major
pathophysiological categories:
– Blood loss
– Impaired red cell production
– Accelerated red cell destruction (hemolysis in
excess of the ability of the marrow to replace
these losses
3. Clinical Signs and Symptoms of
Anemia
Result from diminished delivery of oxygen to the
tissues.
• Related to the lowered hemoglobin concentration.
• Clinical signs reflect the rate of reduction of
hemoglobin and blood volume.
• Anemia also may be classified by red cell
morphology as macrocytic, normocytic, or
microcytic
4. Labortary Assesment
The laboratory investigation of anemias involves
the quantitative and semi quantitative
measurements of erythrocytes.
• Supplementary testing of blood and body fluids.
5. Laboratory Assessment of
Anemias
Quantitative measurements of anemia
– The three major laboratory manifestations of
anemia are as follows:
• A decreased hemoglobin concentration
• A reduced packed cell volume (micro hematocrit)
level
• A decreased erythrocyte concentration
6. Laboratory Assessment of
Anemias
Packed cell volume (microhematocrit), and
erythrocyte count, a variety of other
measurements or calculations can yield additional
information.
• These assessments include the following:
– Red blood cell indices
– The red cell histogram
– Red cell distribution width (RDW) or red cell
morphology index (RCMI)
7. Laboratory Assessment of
Anemias
Semiquantitative grading of erythrocyte
morphology
– Erythrocyte changes are commonly reported
using the following:
• Descriptive terms, such as moderate or marked
• Grades on a numerical scale, such as 1+, 2+, 3+,
or 4
8. Laboratory Assessment of
Anemias
Supplementary assessment of anemias :
– A bone marrow examination may be performed and
may reveal an abnormal ratio of leukocytes to
erythrocytes, the myeloid-erythroid (M:E) ratio.
– Fetal hemoglobin (Hb F) concentration
– Malarial smears
– Platelet count
– Reticulocyte count
– Sickle cell testing
–Glucose-6-phosphate dehydrogenase (G6PD)
assay
– Hemoglobin electrophoresis
9. Laboratory Assessment of
Anemias
Additional procedures include the following:
Antibody screening and identification tests
Direct antiglobulin (AHG) test
Measurements of bilirubin levels
Folic acid assay
Measurement of haptoglobin level
Lactic dehydrogenase (LDH) determination
Serum iron and total iron-binding capacity (TIBC)
Vitamin B12 assay
Occult blood testing
Urobilinogen screening
