Sometimes, for the diagnosis of anemia is not enough, describe the history of the disease, physical examination and peripheral blood smear.
Therefore, the next step in the diagnosis of anemia is to estimate the size of red blood cells. A common cause of microcytic anemia is iron deficiency. “The gold standard” – evaluation of iron stores in the body It can be determined only after the bone marrow aspiration, but the definition of ferritin in serum is more an accurate non-invasive alternative proсedure. The level of vitamin B 12 and folic acid in the serum with the absolute number of reticulocytes can help determine the cause of macrocytic anemia. Alcohol abuse is a common cause of it. Calculation of the absolute reticulocyte count helps in determining the cause normocytic anemia. May be the cause of this – hemolysis, iron deficiency, renal causes, inflammatory and other malignant diseases. For all anemias doctors prescribe treatment aimed at eliminating the causes.
Anemia often enough accidentally diagnosed in outpatients when they routinely donate blood tests.
Anemia may be because of the loss of red blood cells after bleeding or breaking them in hemolysis, and because of insufficient production of these cells as a result of impaired bone marrow function or deficiency of external factors hematopoiesis. Careful evaluation of each patient helps to identify the causes of desease and to influence to them. The diagnosis of anemia is usually the prerogative of the laboratory. However, a thorough history, a careful clinical evaluation can simplify the diagnostic search, thereby reducing the number of necessary laboratory tests and the total cost of the survey. Non-specific symptoms of anemia are weakness, fatigue, pallor, tachycardia, dizziness, and headaches. Sometimes careful analysis of peripheral blood smear can indicate the specific nature of anemia.
If the information obtained from history taking, clinical examination, blood count with the formula, as well as peripheral blood smear is insufficient to establish the survey results, doctor must to apply a systematic approach to diagnosis, based on the size of red blood cells and reticulocyte count. Such tactics at the same time improves the efficiency and reduces the cost of the survey.
Using the index of average volume of red blood cell (mean corpuscular volume – MCV), anemia is classified as follows:
- microcytic (MCV less than 82 fL);
- macrocytic (MCV 95 fL);
- normocytic (MCV between 82 and 95 fL).
Despite the practicality of this classification, it should be noted, however, that there are significant similarities between the various anemias.