hematology and oncology
Evaluation of Anemia
Introduction
Anemia is a decrease in the number of red blood cells (RBCs) as measured by the red cell count, the hematocrit, or the red cell hemoglobin content. In men, anemia is defined as any of the following: Hemoglobin<14 g/dL (140 g/L) Hematocrit<42% (< 0.42) RBC<4.5 million/mcL (< 4.5 × 1012/L) In women, anemia is defined as any of the following: Hemoglobin<12 g/dL (120 g/L) Hematocrit<37% (< 0.37) RBC<4 million/mcL (< 4 × 1012/L) For infants and children, normal values vary with age, necessitating use of age-related tables (see table Age-Specific Values for Hemoglobin and Hematocrit ). Anemia is not a diagnosis; it is a manifestation of an underlying disorder (see Etiology of Anemia ). Thus, even mild, asymptomatic anemia should be investigated so that the primary problem can be diagnosed and treated. Anemia is usually suspected based on the history and physical examination. Common symptoms and signs of anemia include General fatigue Weakness Dyspnea on exertion Pallor History and physical examination are followed by laboratory testing with a complete blood count, reticulocyte count, and peripheral smear. The differential diagnosis (and cause of anemia) can then be further refined based on the results of testing. Anemia is not a diagnosis; it is a manifestation of an underlying disorder. Thus, even mild, asymptomatic anemia should be investigated so that the primary problem can be diagnosed and treated. 