Anemia
Types of Anemia MCV Causes Labs
Microcystic < 80 fL Iron deficiency, Thalassemia, ↓ Hgb, Hct, RBC
Anemia of chronic disease
(sometimes), Sideroblastic ↓ MCV, MCHC
anemia ↑ RDW
Normocystic 80 - 100 fl Acute blood loss, ↓ Hgb, Hct, RBC
Anemia of chronic disease: CKD
MCV, MCHC, RDW
Bone marrow suppression
WNL
Macrocystic > 100 fL B12 deficiency, Folate ↓ Hgb, Hct, RBC
deficiency, Alcohol use, Liver
disease, Hypothyroidism, ↑ MCV, RDW
Medications (methotrexate, MCHC WNL
hydroxyurea)
Anemia, Iron Deficiency
Microcystic Anemia
Risk factors:
- Heavy periods
- GI bleed
- Decrease iron intake
- Decrease absorption
- Pregnancy
Symptoms: SOB
- Fatigue
- Pallor
- Koilonychia
- Pica
Lab findings:
- ↓ Hgb, Hct, RBC
- ↓ MCV
- ↓ ferritin, ↑ TIBC, ↓ serum iron, ↑ RDW.
Treatment:
- Ferrous Sulfate 325 mg orally QD
- Orange Juice
- Treat the underlying cause!
- Iron deficiency in an older person is GI bleeding until proven otherwise. Do a
colonoscopy!
Types of Anemia MCV Causes Labs
Microcystic < 80 fL Iron deficiency, Thalassemia, ↓ Hgb, Hct, RBC
Anemia of chronic disease
(sometimes), Sideroblastic ↓ MCV, MCHC
anemia ↑ RDW
Normocystic 80 - 100 fl Acute blood loss, ↓ Hgb, Hct, RBC
Anemia of chronic disease: CKD
MCV, MCHC, RDW
Bone marrow suppression
WNL
Macrocystic > 100 fL B12 deficiency, Folate ↓ Hgb, Hct, RBC
deficiency, Alcohol use, Liver
disease, Hypothyroidism, ↑ MCV, RDW
Medications (methotrexate, MCHC WNL
hydroxyurea)
Anemia, Iron Deficiency
Microcystic Anemia
Risk factors:
- Heavy periods
- GI bleed
- Decrease iron intake
- Decrease absorption
- Pregnancy
Symptoms: SOB
- Fatigue
- Pallor
- Koilonychia
- Pica
Lab findings:
- ↓ Hgb, Hct, RBC
- ↓ MCV
- ↓ ferritin, ↑ TIBC, ↓ serum iron, ↑ RDW.
Treatment:
- Ferrous Sulfate 325 mg orally QD
- Orange Juice
- Treat the underlying cause!
- Iron deficiency in an older person is GI bleeding until proven otherwise. Do a
colonoscopy!
