Anemia

Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer. If this is your first time visiting, we suggest you read the tutorial.

Initial evaluation

May consist of:

• CBC with differential, MCV
• Basic metabolic panel (BMP)
• Liver function tests (LFTs)
• Reticulocyte count
• Iron, total iron binding capacity (TIBC), ferritin
• Vitamin B12 +/- methylmalonic acid & homocysteine
• Folic acid
• TSH
• Peripheral smear
• Clinical history, lifestyle factors (e.g. alcohol)
• Medications

GI bleeding?

• Stool occult blood
• EGD & colonoscopy

Hemolysis?

• LDH
• Haptoglobin
• Direct & indirect Coombs
• LFTs (direct, indirect, total bilirubin)
• Infectious: anaplasma, babesia, ehrlichia

Anemia of chronic disease/anemia chronic kidney disease

• Basic metabolic panel (BMP) & iron labs as above
• Serum erythropoietin
• ESR
• CRP

Chronic/inherited?

• Hemoglobin electrophoresis
• Sickle cell evaluation

Myeloma?

• SPEP & IFE
• UPEP
• Free serum/urine kappa/lambda light chains
• Skeletal survey

Primary marrow process/hematologic malignancy

• Bone marrow biopsy

Less common

• Copper
• Zinc
• Celiac (TTG IgA)