Canterbury DHB

Context

General Considerations and Causes

In the assessment of anaemia, factors to consider are:

MCV

<80

Consider:

  • Iron deficiency.
  • Anaemia of chronic inflammation.
  • Thalassemia.

80-100

Consider:

  • Recent haemorrhage.
  • Renal failure.
  • Thyroid of other endocrine abnormailty.

>100

Consider:

  • Alcohol excess.
  • B12/folate deficiency.

The anaemia may be primarily due to inadequate formation or excessive destruction, but remember acute blood loss. The main causes are listed in the following table.

Causes of Anaemia

Failure of production

Decreased erythropoietin production

  • Renal disease.
  • Starvation.
  • Endocrine deficiency states, e.g., hypothyroidism.

    Poor bone marrow response to erythropoietin

  • Iron deficiency, anaemia of chronic inflammation, sideroblastic anaemia.
  • B12/folate deficiency, marrow infiltration, MDS, leukaemias.

    Other conditions with reduced bone marrow red cell production

  • Congenital.
  • Pure red cell aplasia.
  • Aplastic anaemia.

Blood loss or excessive destruction

  • Acute bleeding.
  • Thalassaemia, abnormal haemoglobins.
  • Hereditary spherocytosis, elliptocytosis, pyropoikilocytosis.
  • Red cell enzyme deficiencies eg G6PD, PK.
  • Immune mediated red cell defects.
    • Auto immune haemolytic anaemia - idiopathic, secondary, warm, cold.
  • PNH.
  • Microangiopathic haemolytic anaemia.
  • Infections, burns, chemicals, drugs.

About this Canterbury DHB document (7933):

Document Owner:

Mark Smith (see Who's Who)

Issue Date:

August 2017

Next Review:

August 2019

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 7933