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Classification of anemia. Functional classification: Hypoproliferative destruction (infective hematopoiesis). Clinical classification: Causes of anemia (blood loss, IDA, hemolysis). Quantitative classification: Hematocrit Hemoglobin Blood cell indices (MCV, MCH, MCHC).

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classification of anemia
Classification of anemia
  • Functional classification:
    • Hypoproliferative destruction (infective hematopoiesis).
  • Clinical classification:
    • Causes of anemia (blood loss, IDA, hemolysis).
  • Quantitative classification:
    • Hematocrit
    • Hemoglobin
    • Blood cell indices (MCV, MCH, MCHC).
    • Reticulocytes count.
red cell indices
Red cell indices
  • MCV (mean corpuscular volume)
    • The average volume of RBC

Hct

=  10 (fl)

RBC count (m/µL)

e.g. Hct= 40%

RBC=5.0 (m /µL)

MCV= 40/5.0  10 = 80 fl

NR= 80-96 fl

slide3
MCH (mean corpuscular hemoglobin)
    • The average content of Hb in average RBC.
    • It is directly proportional to the amount of Hb and RBC size.

Hb

 10 (pg)

MCH =

RBC count (m/µL)

e.g. Hb = 14 g/dl

RBC = 4 (m/µL)

MCH= 14/4  10

= 35 pg

NR= 27-32 pg

slide4
MCHC (mean corpuscular hemoglobin concentration)
    • Express the average concentration of hemoglobin per unit volume of RBC.
    • It defined as the ratio of the weight of hemoglobin to volume of RBC.

Hb (g/dl)

 100 (%)

MCHC=

Hct (%)

e.g. Hb = 14 g/dl

Hct = 45 %

MCHC 14/45  100 = 31%

NR= 32-36%

slide5

Symptoms of Anemia

Normal or High

Hemoglobin/Hematocrit

Check other

Causes of symptoms

e.g. Cardiac Pulmonary

Low

RBC indices

MCV > 98

MCV=80-96

MCV < 80

MCHC < 32

History of acute blood loss

Auto immune Hemolytic anemia

Anemia of chronic Diseases

Anemia of infection

B12 and folate levels

Serum iron and Total Iron binding capacity of Ferritin

Normal

Hb electrophoresis for Thala.

Low Iron

IDA, chronic diseases, Renal diseases

High Iron

BM exam

For Sideroblastic anemia

Low B12

PA, GI problems

Severe malnutrition.

Low folate

Folate malnutrition

GI problems

Liver disease

High or Normal

MPD

Liver Disease

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Hypochromic Hyperchromic

Macrocytic Microcytic

slide8

IDA

Stomatocytes

Target cells

Sickle cells

Poikiolocytosis

Acanthocytes

Spherocytes

Nucleated RBC

Ovalocyte