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Workup of anaemia

Workup of anaemia in Yeshwanthpur, Bangalore

The first step in anaemia diagnosis is detection with reliable, accurate tests so that important clues to underlying disease are not missed, and patients are not subjected to unnecessary treatment and tests for nonexistent anaemia. The detection of anaemia requires the use of arbitrary criteria. According to the World Health Organisation (WHO), a haemoglobin (Hb) concentration of less than 12. 5 g/dL is defined as an anaemic condition in adults.

Routine Anaemia Workup

  • The patient's comprehensive clinical history for diagnosis, physical examination, signs and symptoms, and the following lab workup are all required for routine anaemia workup.

  • Haemoglobin and hematocrit levels are checked.

  • The count of red blood cells is checked.

  • Indices of blood - average red blood cell size (MCV), haemoglobin amount per red blood cell (MCH) The amount of haemoglobin relative to the size of the cell (haemoglobin concentration) per red blood cell (MCHC). To know more about Workup of anaemia in Yeshwanthpur, Bangalore, visit Manipal hospitals.

  • MCH is only of limited use in the differential diagnosis of anaemias. This is known as instrumental calibration.

  • MCHC is also used for instrumental calibration, and alterations occur late in iron-deficiency anaemia when the anaemia is severe. This is a better way to assess hyperchromasia than MCH.

  • With the use of MCV, red cell distribution width (RDW) assists in classifying anaemia.

  1. RDW is more susceptible to microcytic anaemia 

  2. This is useless for those who do not have anaemia.

  • Iron in serum (normal = 50 to 150 g/dL).

  1. Anaemia may be diagnosed using serum total iron levels.

  2. It distinguishes hemochromatosis from hemosiderosis.

  3. It should be tested in conjunction with TIBC to assess an iron deficiency.

  4. This also aids in determining acute iron poisoning in youngsters.

  • Total iron-binding capacity (TIBC = Normal = 250 to 450 g/dL) is a measure of the amount of iron in the blood.

  1. It aids in the differentiation of anaemia.

  2. It should be done in conjunction with serum iron to determine the percentage saturation for the diagnosis of iron deficiency anaemia.

  • Transferrin: A serum transferrin level is required for D/D anaemia.

  • Transferrin saturation as a percentage (normal transferrin saturation ranges from 20% to 50%).

  1. % transferrin saturation = Serum iron TIBC x 100 = Transferrin is usually 33% saturated.

  2. This is used for anaemias with D/D.

  3. This aids in the diagnosis of hereditary spherocytosis.

  • Serum ferritin (normal range = 20 to 250 ng/dL).

  1. It is related to total body iron reserves.

  2. It distinguishes between iron insufficiency and iron excess.

  3. It is related to total iron reserves in the body.

  4. It will forecast and track iron deficiency.

  5. It will provide information on the efficiency of iron-deficiency anaemia therapy.

  6. It distinguishes between iron deficiency and chronic illnesses.

  7. It assesses the iron status of individuals with chronic renal disease who are on or off dialysis.

  8. It is used to investigate the iron levels of the population and their response to iron supplementation.

  9. It is capable of detecting the iron overload and monitoring iron buildup.

  10. It can aid in guiding the response to iron deficiency treatment.

  • Smear of peripheral blood.

  1. This will reveal any irregularities in RBC shape, size, or inclusions.

  2. There is a dimorphic image with a combined iron, vitamin B12, or folate insufficiency; there are microcytes and macrocytes. Blood indices may be normal in this scenario.

  3. The test also looks for aberrant white cells and evaluates the platelets.

  4. It can detect blast cells such as normoblast or granulocyte blast cells. Book an appointment with us for the best tests and treatments.

  • Count of reticulocytes

  1. The usual range is 0.5 to 2.5%, with an absolute count ranging from 25 to 125 x 109/L.

  2. Anaemia causes an increase in reticulocytes due to an increase in erythropoietin levels.

  3. Erythropoietin levels rise in 6 hours after an acute haemorrhage.

  4. Reticulocyte levels rise in 2 to 3 days, reaching a peak in 6 to 10 days.

  5. Reticulocytes will be increased till the Hb returns to normal.

  6. In the event of anaemia, a low reticulocyte count indicates a bone marrow problem or a lack of erythropoietin stimulation.

  • Platelets and white blood cells are counted. This will rule out pancytopenia caused by anaemia.

  1. Neutrophils and platelets are increased during hemolysis or bleeding.

  2. White blood cells are also increased in leukaemias.

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