Editing Anaemia (section)

== '''Diagnostic approach based on reticulocyte count''' ==

* Decreased (or inappropriately low)
** Deficiency of iron, B12, folate or copper
** Medications that suppress the bone marrow
** Primary bone marrow disorders (MDS, myelofibrosis, leukaemia)
** Very recent bleeding within 5-7 days, pre-compensation
* Increased
** Haemolysis
** Repletion of deficient iron, B12, folate or copper
** Recovery from bleeding

{| class="wikitable"
|'''RBC size/'''

'''MCV'''
|'''Reticulocyte count'''
|
|-
|
|'''Low or normal*'''
|'''Increased'''
|-
|'''Microcytic'''

MCV <80 fL
|
** Iron deficiency (late)
** Anemia of chronic disease/inflammation
** Sideroblastic anemias
|
** Thalassemia
** Hemolysis¶
|-
|'''Normocytic'''

MCV 80 to 100 fL
|
** Bleeding (acute)
** Iron deficiency (early)
** Anemia of chronic disease/inflammation
** Bone marrow suppression (cancer, aplastic anemia, infection)
** Chronic renal insufficiency
** Hypothyroidism
** Hypopituitarism
** Excess alcohol
** Copper deficiency/zinc poisoning
|
** Bleeding (with bone marrow recovery)
** Hemolysis¶
** Bone marrow recovery (eg, after infection, vitamin B12 or folate replacement, and/or iron replacement)
|-
|'''Macrocytic'''

MCV >100 fL
|
** Vitamin B12 or folate deficiency
** Excess alcohol
** Myelodysplastic syndrome
** Liver disease
** Hypothyroidism
** HIV infection
** Medications that interfere with nuclear maturation (hydroxyurea, methotrexate, some chemotherapy agents)
|
** Hemolysis¶
** Bone marrow recovery (eg, after infection, vitamin B12 or folate replacement, and/or iron replacement)
|}