Normocytic anemia
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Differentiating Normocytic Anemia from Other Diseases
To review the differential diagnosis of anemia, click here.
Disease | Genetics | Clinical manifestation | Lab findings | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
History | Symptoms | Signs | Hemolysis | Intrinsic/Extrinsic | Hb concentration | MCV | RDW | Reticulocytosis | Haptoglobin levels | Hepcidin | Iron studies | Specific finding on blood smear | ||||||
Serum iron | Serum Tfr level | Transferrin or TIBC | Ferritin | Transferrin saturation | ||||||||||||||
Iron deficiency anemia (early phase)[1] | − |
|
− | − | Normochromic | Normocytic | ↑ | ↓ | Nl | Nl | ↓ | ↑ | ↑ | ↓ | ↓ |
| ||
G6pd deficiency[2] |
|
+ | Intrinsic | Normochromic | Normocytic | ↑ | ↑ but usually causes resolution within 4-7 days | ↓ | ↓ | Nl to ↑ | Nl | ↑ | ↑ | ↑ |
| |||
Pyruvate kinase deficiency[3] |
|
|
|
+ | Intrinsic | Normochromic | Normocytic | ↑ | ↑ | ↓ | Nl | ↑ | Nl | Nl | ↑ | − |
| |
Disease | Genetics | History | Symptoms | Signs | Hemolysis | Intrinsic/Extrinsic | Hb concentration | MCV | RDW | Reticulocytosis | Haptoglobin levels | Hepcidin | Serum iron | Serum Tfr level | IBC | Ferritin | Transferrin saturation | Specific finding on blood smear |
Sickle cell anemia[4] |
|
|
+ | Intrinsic | Normochromic | Normocytic | ↑ | ↑ | ↓ | Nl or moderately ↑ | Nl | Nl | Nl or moderately ↑ | ↓ | Nl |
| ||
HbC disease[5] |
|
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+ | Intrinsic | Normochromic | Normocytic | ↑ | ↑ | ↓ | Nl | Nl | Nl | Nl | ↓ | − |
| ||
Paroxysmal nocturnal hemoglobinuria[6][7] |
|
|
|
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+ | Intrinsic | Normochromic | Normocytic | ↑ | ↑ | ↓ | Nl | ↓ | Nl | ↑ | ↓ | − | NA |
Hereditary spherocytosis[8] |
|
|
+ | Intrinsic | Normochromic | Normocytic | ↑ | ↑ | ↓ | Nl | ↓ | Nl | ↑ | Nl | − |
| ||
Disease | Genetics | History | Symptoms | Signs | Hemolysis | Intrinsic/Extrinsic | Hb concentration | MCV | RDW | Reticulocytosis | Haptoglobin levels | Hepcidin | Serum iron | Serum Tfr level | IBC | Ferritin | Transferrin saturation | Specific finding on blood smear |
Microangiopathic hemolytic anemia[9][10] | − | Associated with |
|
+ | Extrinsic | Normochromic | Normocytic | ↑ | ↑ | ↓ | Nl | ↓ | Nl | − | ↑ | − |
| |
Macroangiopathic hemolytic anemia[11] | Associated with | + | Extrinsic | Normochromic | Normocytic | ↑ | ↑ | ↓ | Nl | ↓ | Nl | − | − | − | ||||
Autoimmune hemolytic anemia[12] | − | Associated with: |
|
|
+ | Extrinsic | Normochromic | Normocytic | ↑ | ↑ | ↓ | Nl | ↓ | Nl | − | − | − |
|
Disease | Genetics | History | Symptoms | Signs | Hemolysis | Intrinsic/Extrinsic | Hb concentration | MCV | RDW | Reticulocytosis | Haptoglobin levels | Hepcidin | Serum iron | Serum Tfr level | IBC | Ferritin | Transferrin saturation | Specific finding on blood smear |
Aplastic anemia[13] |
|
|
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− | − | Normochromic | Normocytic | ↑ | ↓ | Nl | Nl | ↓ | ↓ | Nl | ↑ | ↓ |
| |
Infections[14] | − | Associated with | + | Extrinsic | Normochromic | Normocytic | ↑ | ↑ | ↓ | Nl | Nl | Nl | − | − | − |
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Chronic kidney disease[15] | − | − | − | Normochromic | Normocytic | ↑ | Nl/↑ | Nl | ↑ | ↓ | − | ↓ | ↑ | ↓ | Nl | |||
Disease | Genetics | History | Symptoms | Signs | Hemolysis | Intrinsic/Extrinsic | Hb concentration | MCV | RDW | Reticulocytosis | Haptoglobin levels | Hepcidin | Serum iron | Serum Tfr level | IBC | Ferritin | Transferrin saturation | Specific finding on blood smear |
References
- ↑ De Andrade Cairo RC, Rodrigues Silva L, Carneiro Bustani N, Ferreira Marques CD (June 2014). "Iron deficiency anemia in adolescents; a literature review". Nutr Hosp. 29 (6): 1240–9. doi:10.3305/nh.2014.29.6.7245. PMID 24972460.
- ↑ Luzzatto L, Seneca E (February 2014). "G6PD deficiency: a classic example of pharmacogenetics with on-going clinical implications". Br. J. Haematol. 164 (4): 469–80. doi:10.1111/bjh.12665. PMC 4153881. PMID 24372186.
- ↑ Grace RF, Zanella A, Neufeld EJ, Morton DH, Eber S, Yaish H, Glader B (September 2015). "Erythrocyte pyruvate kinase deficiency: 2015 status report". Am. J. Hematol. 90 (9): 825–30. doi:10.1002/ajh.24088. PMC 5053227. PMID 26087744.
- ↑ Singh PC, Ballas SK (March 2015). "Emerging drugs for sickle cell anemia". Expert Opin Emerg Drugs. 20 (1): 47–61. doi:10.1517/14728214.2015.985587. PMID 25431087.
- ↑ Lemonne N, Billaud M, Waltz X, Romana M, Hierso R, Etienne-Julan M, Connes P (2016). "Rheology of red blood cells in patients with HbC disease". Clin. Hemorheol. Microcirc. 61 (4): 571–7. doi:10.3233/CH-141906. PMID 25335812.
- ↑ Bunyaratvej A, Butthep P (January 1992). "Cytometric analysis of paroxysmal nocturnal hemoglobinuria erythrocytes". J Med Assoc Thai. 75 Suppl 1: 237–42. PMID 1402472.
- ↑ Kahng J, Kim Y, Kim JO, Koh K, Lee JW, Han K (January 2015). "A novel marker for screening paroxysmal nocturnal hemoglobinuria using routine complete blood count and cell population data". Ann Lab Med. 35 (1): 35–40. doi:10.3343/alm.2015.35.1.35. PMC 4272963. PMID 25553278.
- ↑ Da Costa L, Galimand J, Fenneteau O, Mohandas N (July 2013). "Hereditary spherocytosis, elliptocytosis, and other red cell membrane disorders". Blood Rev. 27 (4): 167–78. doi:10.1016/j.blre.2013.04.003. PMID 23664421.
- ↑ Morishita E (July 2015). "[Diagnosis and treatment of microangiopathic hemolytic anemia]". Rinsho Ketsueki (in Japanese). 56 (7): 795–806. doi:10.11406/rinketsu.56.795. PMID 26251142.
- ↑ George JN, Charania RS (March 2013). "Evaluation of patients with microangiopathic hemolytic anemia and thrombocytopenia". Semin. Thromb. Hemost. 39 (2): 153–60. doi:10.1055/s-0032-1333538. PMID 23390027.
- ↑ Westphal RG, Azen EA (May 1971). "Macroangiopathic hemolytic anemia due to congenital cardiovascular anomalies". JAMA. 216 (9): 1477–8. PMID 5108522.
- ↑ Hill QA (October 2015). "Autoimmune hemolytic anemia". Hematology. 20 (9): 553–4. doi:10.1179/1024533215Z.000000000401. PMID 26447931.
- ↑ Dolberg OJ, Levy Y (2014). "Idiopathic aplastic anemia: diagnosis and classification". Autoimmun Rev. 13 (4–5): 569–73. doi:10.1016/j.autrev.2014.01.014. PMID 24424170.
- ↑ Bustinduy AL, Parraga IM, Thomas CL, Mungai PL, Mutuku F, Muchiri EM, Kitron U, King CH (March 2013). "Impact of polyparasitic infections on anemia and undernutrition among Kenyan children living in a Schistosoma haematobium-endemic area". Am. J. Trop. Med. Hyg. 88 (3): 433–40. doi:10.4269/ajtmh.12-0552. PMC 3592521. PMID 23324217.
- ↑ Drawz P, Rahman M (June 2015). "Chronic kidney disease". Ann. Intern. Med. 162 (11): ITC1–16. doi:10.7326/AITC201506020. PMID 26030647.