Classification of anemia

Functional classification:

Hypoproliferative destruction (infective

hematopoiesis).

Clinical classification:
Causes of anemia (blood loss, IDA, hemolysis).

Quantitative classification:

Hematocrit
Hemoglobin
Blood cell indices (MCV, MCH, MCHC).
Reticulocytes count.

Red cell indices

MCV (mean corpuscular volume)
The average volume of RBC
Hct
=
10 (fl)
RBC count (m/L)
e.g.
Hct= 40%
RBC=5.0 (m /L)
MCV= 40/5.0 10 = 80 fl
NR= 80-96 fl

MCH (mean corpuscular hemoglobin)

The average content of Hb in average RBC.

It is directly proportional to the amount of Hb
and RBC size.

MCH =

e.g.

Hb

10
RBC count (m/L)
Hb = 14 g/dl
RBC = 4 (m/L)
MCH= 14/4 10
= 35 pg
NR= 27-32 pg

(pg)

MCHC (mean corpuscular hemoglobin

concentration)

Express the average concentration of

hemoglobin per unit volume of RBC.
It defined as the ratio of the weight of
hemoglobin to volume of RBC.

MCHC=

Hb (g/dl)

100 (%)

Hct (%)
e.g.

Hb = 14 g/dl
Hct = 45 %
MCHC 14/45 100 = 31%

NR= 32-36%

Symptoms of Anemia
Normal or High

Hemoglobin/Hematocrit

Check other
Causes of symptoms
e.g. Cardiac
Pulmonary

Low
RBC indices
MCV=80-96

MCV > 98

History of acute blood loss

Auto immune Hemolytic anemia
Anemia of chronic Diseases
Anemia of infection

B12 and folate

levels

MCV < 80
MCHC < 32
Serum iron and Total
Iron binding capacity
of Ferritin

Low Iron

Normal

High Iron

IDA, chronic
diseases, Renal
diseases

Hb
electrophoresis
for Thala.

BM exam
For
Sideroblastic
anemia

Low B12
PA, GI
problems
Severe
malnutrition.

Low folate

High or Normal

Folate
malnutrition
GI problems
Liver disease

MPD
Liver Disease

Normal red cell morphology

Hypochromic

Macrocytic

Hyperchromic

Microcytic

IDA

Poikiolocytosis

Ovalocyte

Target cells

Stomatocytes

Sickle cells

Acanthocytes

Spherocytes

Nucleated RBC