1. Anemia without increased reticulocytes
Iron deficiency anemia
Clinical suspicion: Microcytic hypochromic anemia.
Clinical suspicion: microcytic hypochromic anemia without increase in
reticulocyte count not caused by iron deficiency with morphological
abnormalities in peripheral blood smear. In severe cases bone abnormalities
Clinical suspicion: Normocytic anemia & reticulocytopenia not diagnosed
conventionally will require a bone marrow aspirate and subsequently
a bone marrow biopsy OR macrocytic anemia not found to be due to folate
or B12 deficiencies. More advanced cases may present with evidence of
Clinical suspicion: Anemia with thrombocytopenia or pancytopenia with
reticulocytopenia. Bone marrow aspirate often shows dry tap.
Anemia of chronic diseases.
Is almost always due to
Clinical suspicion: Macrocytic anemia with absolute
Diagnosis: Serum B12 and RBC folate are measured.
If results of above are equivocal then both methylmalonic
acid and homocysteine are measured. Both are elevated in B12 deficiency
whilst only homocysteine is elevated in folate deficiency.
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