Hematology: Anemia and Bone Marrow Disorders Practice

Anemia classification by MCV and RI, and diagnostic features of specific hematologic disorders including IDA, B12 deficiency, AA, G6PD, SCD, HS, and PNH.

Microcytic Anemia ($MCV < 80$)

Anemia characterized by a mean corpuscular volume less than 80, including Iron Deficiency Anemia (IDA), Anemia of Chronic Disease (ACD), thalassemia, and sideroblastic anemia.

Normocytic Anemia ($MCV = 80-100$)

Anemia with a mean corpuscular volume between 80 and 100, typically caused by acute blood loss, hemolysis, or Aplastic Anemia (AA).

Macrocytic Anemia ($MCV > 100$)

Anemia with a mean corpuscular volume greater than 100; categorized as megaloblastic (B12/folate deficiency) or non-megaloblastic (liver disease, alcohol, MDS).

Reticulocyte Index ($RI$)

A guide to marrow response where an $RI < 2$ indicates underproduction and an $RI > 2$ indicates destruction or loss, used to evaluate normocytic anemias.

Iron Deficiency Anemia (IDA) Diagnosis

Diagnosed by low ferritin and increased Total Iron Binding Capacity ($TIBC$); treated with iron supplementation.

B12 Deficiency

A condition presenting with neurological symptoms, glossitis, and elevated levels of Methylmalonic acid ($MMA$) and Homocysteine ($Homo$).

Aplastic Anemia ($AA$)

Characterized by pancytopenia and a hypocellular bone marrow, with no specific findings on a peripheral smear ($PS$).

G6PD Deficiency

A condition where triggers lead to the formation of bite cells and Heinz bodies, causing intravascular ($IV$) hemolysis.

Sickle Cell Disease ($SCD$)

Presents with anemia, pain, hyposplenism, acute chest syndrome, priapism, and risk of stroke or Vascular Dementia ($VaD$).

Hereditary Spherocytosis ($HS$)

A condition often involving family history (Ankyrin defect), negative Direct Coombs Test ($DCT-ve$), and risk of bilirubin or gallbladder ($GB$) stones.

EMA binding

The Investigation of Choice ($IOC$) for Hereditary Spherocytosis, which shows a decreased ($↓$) result.

HS Screening Tests

Includes the Osmotic Fragility Test ($OFT$) and the Acidified Glycerol Lysis Test ($AGLT$).

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Characterized by $CD55/59 -ve$ status, pancytopenia, hemolysis ($DCT-ve$), and high thromboembolic ($TE$) risk.

FLAER

Fluorescently labeled aerolysin, which is the Investigation of Choice ($IOC$) for Paroxysmal Nocturnal Hemoglobinuria ($PNH$).