AnemiaComments Off on Anemia
Anemia is characterized as a condition where there is a low hematocrit – hemoglobin.
ESSENTIAL CASES OF APPEARANCE
Anemias are among the main topics of hematology, with multidimensional etiology and translation. We briefly mention:
a. At younger ages, anemia is mainly observed by:
- gene type – thalassemia (Mediterranean anemia marker)
- poor nutrition – lack of hematopoietic factors (eg diets in animal derivatives)
- malabsorption of hemopoietic trace elements (iron, folic acid, vitamin B12) due to stomach disorders (celiac disease, intolerances, gastritis etc.)
- gynecologically intense blood loss during menstruation
b. In older ages, anemia can be caused inter alia by:
- loss of blood (mainly from the gastrointestinal tract)
- bone marrow dysplasia – haematological diseases
- prolonged immobility – renal failure
- autoimmune diseases and malignant diseases
- use of drugs that suppress the bone marrow or cause malabsorption of hematopoietic trace elements
LABORATORY HEMATOLOGICAL TESTING (basic blood tests)
Complete Blood Count (CBC)
Anemia diagnosis relies on low hematocrit (HCT) and hemoglobin (HGB) measurement .
Aadditional red blood cell parameters give information on the etiology – type of anemia
- mean volume of red (MCV) with indirect information on iron deficiency (-), lack of hematopoietic vitamins (+), dysplasia (+), Mediterranean stigma (-) etc
- mean content and hemoglobin concentration (MCH, MCHC) that is mainly evaluated for iron
- (RDW-CV), which is mainly evaluated for the signs of Mediterranean anemia, medullary dysplasia and red cell renewal
Microscopic blood test:
Morphology and quality of all blood cells (red, white, platelets) with microscopic examination is used for further categorization of anemia, while assessment for possible underline hematologic disease or dysplasia is done.
Erythrocyte sedimentation rate (ESR)
It is used to detect long-term inflammatory disease or serious disease of the marrow, or other central disease that may have caused anemia.
They show the red cell renewal rate by giving information on marrow productivity
Iron (Fe) and its basic stores ferritin (Ferr) and transferrin (Trf)
These tests assess the adequacy of iron in the body with conclusions of possible loss or malabsorption. Simple iron measurement is not enough, since iron is very fluctuating from day to day, and is heavily influenced by possible inflammations with ‘falsely low’ values. T
Iron Ties (TIBC) and Transferrin Saturation (TfS)
Provide information on the adequate transfer of iron into the body, and its ability to absorb it.
C Reactive Protein (CRP)
Auxiliary test for detection
– inflammation that can give ‘false’ values in iron, ferritin and transferrin
– detection of serious diseases that can cause anemia
Folic acid and vitamin B12 (Vit B12)
Thease are the most essential hematopoietic vitamins. We often find them low in people with poor nutrition or malnutrition and in people who have difficulty absorbing them due to stomach upset, malabsorption, age or drug use.
Lactic dehydrogenase (LDH) and total bilirubin (TBil) :
These tests examine the normal blood regeneration pathway, and exclude hemolysis – destruction of blood within the body.
Autologous Celiac disease (IgG / IgA antibodies, IgG / IgM tissue traglutaminase, and intramuscular IgG / IgM antibodies)
These antibodies detect possible celiac disease, a condition characterized by gluten intolerance and inhibition of the absorption of iron, vitamin B12 and folate. The tests are particularly recommended in cases of undetectable long-term failure to maintain ferritin levels, B12 after treatment.
Femoral hemoglobin (HGBocc)
Recommended for acute phase iron deficiency and for suspected people for gastrointestinal blood loss.
Information selected from :
- Interpretation of Diagnostic Tests – J.Wallach
The exact choice of tests required, is under the responsibility of your treating physician
Editor: I. Gratsias Lab Director / Clinical Biochemist
Last Update May 2019