What steps should be taken to determine the etiology of anemia?

Updated: Nov 26, 2019
  • Author: Joseph E Maakaron, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Often, the etiology of a patient’s anemia can be determined if the red blood cells (RBCs) are altered in either size or shape or if they contain certain inclusion bodies. For example, Plasmodium falciparum malaria is suggested by the presence of more than one ring form in an RBC, and the infection produces pan-hemolysis of RBCs of all ages.

A rational approach to determining etiology is to begin by examining the peripheral smear and laboratory values obtained on the blood count. If the anemia is microcytic (mean corpuscular volume [MCV] < 84 fL) or macrocytic (MCV >96 fL) or if certain abnormal RBCs or white blood cells (WBCs) are observed in the blood smear, the investigative approach can be limited.

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