Classification of anemia Classification of anemia
• Functional classification:Functional classification:
• Hypoproliferative destruction (infective Hypoproliferative destruction (infective hematopoiesis).
hematopoiesis).
• Clinical classification:Clinical classification:
• Causes of anemia (blood loss, IDA, hemolysis).Causes of anemia (blood loss, IDA, hemolysis).
• Quantitative classification:Quantitative classification:
• HematocritHematocrit
• HemoglobinHemoglobin
• Blood cell indices (MCV, MCH, MCHC).Blood cell indices (MCV, MCH, MCHC).
• Reticulocytes count.Reticulocytes count.
Red cell indices Red cell indices
MCV (mean corpuscular volume) MCV (mean corpuscular volume)
The average volume of RBCThe average volume of RBC HctHct
== 10 10 (fl)(fl) RBC count (m/µL)
RBC count (m/µL) e.g.
e.g. Hct= 40%Hct= 40%
RBC=5.0 (m /µL) RBC=5.0 (m /µL) MCV= 40/5.0
MCV= 40/5.0 10 = 80 fl 10 = 80 fl NR= 80-96 fl
NR= 80-96 fl
MCH (mean corpuscular hemoglobin) MCH (mean corpuscular hemoglobin)
The average content of Hb in average RBC. The average content of Hb in average RBC.
It is directly proportional to the amount of Hb It is directly proportional to the amount of Hb and RBC size.
and RBC size.
Hb
RBC count (m/µL)(m/µL)
10 (pg) MCH =
e.g. Hb = 14 g/dl
RBC = 4 (m/µL) (m/µL)
MCH= 14/4 10 = 35 pg
MCHC (mean corpuscular hemoglobin MCHC (mean corpuscular hemoglobin
concentration) concentration)
Express the average concentration of Express the average concentration of hemoglobin per unit volume of RBC.
hemoglobin per unit volume of RBC.
It defined as the ratio of the weight of It defined as the ratio of the weight of hemoglobin to volume of RBC.
hemoglobin to volume of RBC.
Hb (g/dl) Hct (%)
100 (%) MCHC=
e.g. Hb = 14 g/dl Hct = 45 %
MCHC 14/45 100 = 31%
NR= 32-36%
Symptoms of Anemia
Hemoglobin/Hematocrit Normal or High
Check other
Causes of symptoms e.g. Cardiac
Pulmonary Low
RBC indices
MCV < 80 MCHC < 32
Serum iron and Total Iron binding capacity of Ferritin
Low Iron
IDA, chronic diseases, Renal diseases
Normal
Hb
electrophoresis for Thala.
High Iron
BM exam For
Sideroblastic anemia
MCV=80-96
History of acute blood loss
Auto immune Hemolytic anemia Anemia of chronic Diseases
Anemia of infection
MCV > 98
B12 and folate levels
Low B12
PA, GI problems Severe
malnutrition.
Low folate
Folate
malnutrition GI problems Liver disease
High or Normal
MPD
Liver Disease
Normal red cell morphology
Hypochromic Hyperchromic
IDA
Target cells
Sickle cells Poikiolocytosis
Stomatocytes
Acanthocytes
Ovalocyte Spherocytes
Nucleated RBC
