Hypochromic anemia: Difference between revisions

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VisualWikitext

Latest revision as of 16:52, 16 October 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hypochromic anemia is a form of anemia characterized by a disproportionate reduction of red cell hemoglobin in proportion to the volume of the erythrocyte and an increased area of central pallor in the red cells.

Acquired forms

Hypochromic anemia may be caused by iron deficiency from a low iron intake, diminished iron absorption, or excessive iron loss. It can also be caused by infections or other diseases, therapeutic drugs such as Meropenem, and lead poisoning. One acquired form of anemia is also known as Faber's syndrome. It may also occur from severe stomach or intestinal bleeding caused by ulcers or medications such as aspirin.^[1]

Hereditary forms

It can also occur in certain forms of congenital developmental disorders, like Benjamin syndrome.

Differentiating Hypochromic 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
		History	Symptoms	Signs	Hemolysis	Intrinsic/Extrinsic	Hb concentration	MCV	RDW	Reticulocytosis	Haptoglobin levels	Hepcidin	Serum iron	Serum Tfr level	Transferrin or TIBC	Ferritin	Transferrin saturation	Specific finding on blood smear
Iron deficiency anemia^[2]	−	Menorrhagia GI loss GI surgery Pregnancy	Koilonychia Pica	Glossitis Cheilosis Dysphagia	−	−	Hypochromic	Microcytic	↑	Nl or ↓	Nl	Nl	↓	↑	↑	↓	↓↓↓	Central pallor
Lead poisoning^[3]	−	House painted with chipped paint	Burtonian lines Basophilic stippling Wrist drop Foot drop	Wrist drop Foot drop Burtonian lines	−	−	Hypochromic	Microcytic	Nl	Nl or ↓	Nl	Nl	Nl to ↓	Nl	Nl	Nl to ↓	−	RBCs retain aggregates of rRNA Basophilic stippling
Sideroblastic anemia^[4]	Defect in ALA synthase gene Autosomal dominant Autosomal recessive X-linked	Alcohol abuse Isoniazid use Chloramphenicol use Idiopathic	Seborrheic dermatitis Glossy Tongue Tingling	Patient present with symptoms of Vitamin B6, copper deficiency symptoms	−	−	Hypochromic	Microcytic	Nl	Nl or ↓	Nl	Nl	↑	Nl	Nl to ↓	↑	−	Ringed sideroblasts
Anemia of chronic disease^[5]	−	Rheumatoid arthritis SLE Neoplasm Chronic kidney disease	Headache Shortness of breath	−	−	−	Hypochromic	Microcytic	Nl	Nl or ↓	Nl	↑	↓	Nl	↓	↑	−	NA
Thalassemia^[6]	α-thalassemia α- globin gene deletions Cis deletions Trans deletions β-thalassemia Point mutation in splice sites and promoter sequences	Associated with parvovirus B19	α-thalassemia Hydrops fetalis β-thalassemia Skeletal deformities Chipmunk facies	Hepatomegaly Splenomegaly	−	−	Hypochromic	Microcytic	Nl	Thalassemia trait: Nl or ↓ Thalassemia Syndromes: ↑	Nl	Nl	Nl to ↑	Nl	Nl	↑	Nl to ↑	Target cells Anisopoikilocytosis
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

↑ Miale JB (1982). Laboratory Medicine: Hematology. (6th ed.) The CV Mosby Company, St. Louis ISBN 1-125-44734-6
↑ Camaschella C (May 2015). "Iron-deficiency anemia". N. Engl. J. Med. 372 (19): 1832–43. doi:10.1056/NEJMra1401038. PMID 25946282.
↑ Bain BJ (December 2014). "Lead poisoning". Am. J. Hematol. 89 (12): 1141. doi:10.1002/ajh.23852. PMID 25220013.
↑ Bottomley SS, Fleming MD (August 2014). "Sideroblastic anemia: diagnosis and management". Hematol. Oncol. Clin. North Am. 28 (4): 653–70, v. doi:10.1016/j.hoc.2014.04.008. PMID 25064706.
↑ Roy CN (2010). "Anemia of inflammation". Hematology Am Soc Hematol Educ Program. 2010: 276–80. doi:10.1182/asheducation-2010.1.276. PMID 21239806.
↑ Zainal NZ, Alauddin H, Ahmad S, Hussin NH (December 2014). "α-Thalassemia with Haemoglobin Adana mutation: prenatal diagnosis". Malays J Pathol. 36 (3): 207–11. PMID 25500521.

[1] Miale JB (1982). Laboratory Medicine: Hematology. (6th ed.) The CV Mosby Company, St. Louis ISBN 1-125-44734-6

[pmid25946282-2] Camaschella C (May 2015). "Iron-deficiency anemia". N. Engl. J. Med. 372 (19): 1832–43. doi:10.1056/NEJMra1401038. PMID 25946282.

[pmid25220013-3] Bain BJ (December 2014). "Lead poisoning". Am. J. Hematol. 89 (12): 1141. doi:10.1002/ajh.23852. PMID 25220013.

[pmid25064706-4] Bottomley SS, Fleming MD (August 2014). "Sideroblastic anemia: diagnosis and management". Hematol. Oncol. Clin. North Am. 28 (4): 653–70, v. doi:10.1016/j.hoc.2014.04.008. PMID 25064706.

[pmid21239806-5] Roy CN (2010). "Anemia of inflammation". Hematology Am Soc Hematol Educ Program. 2010: 276–80. doi:10.1182/asheducation-2010.1.276. PMID 21239806.

[pmid25500521-6] Zainal NZ, Alauddin H, Ahmad S, Hussin NH (December 2014). "α-Thalassemia with Haemoglobin Adana mutation: prenatal diagnosis". Malays J Pathol. 36 (3): 207–11. PMID 25500521.

[1]

[2]

[3]

[4]

[5]

[6]

@@ Line 69: / Line 69: @@
 | align="left" style="background:#F5F5F5;" |
 * Central [[pallor]]
-|-
-! align="center" style="background:#DCDCDC;" |[[Iron deficiency anemia]] (early phase)<ref name="pmid24972460">{{cite journal |vauthors=De Andrade Cairo RC, Rodrigues Silva L, Carneiro Bustani N, Ferreira Marques CD |title=Iron deficiency anemia in adolescents; a literature review |journal=Nutr Hosp |volume=29 |issue=6 |pages=1240–9 |date=June 2014 |pmid=24972460 |doi=10.3305/nh.2014.29.6.7245 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" |
-* [[Pica]]
-* [[Glossitis]]
-* [[Angular cheilitis|Cheilosis]]
-| align="left" style="background:#F5F5F5;" |
-* [[Fatigue]]
-* [[Headache]]
-| align="left" style="background:#F5F5F5;" |
-* [[Koilonychia]]
-* Conjunctival [[pallor]]
-* [[Xeroderma|Dry skin]]
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | ↓
-| align="left" style="background:#F5F5F5;" |
-* Pencil [[Cell (biology)|cells]]
-* [[Hereditary elliptocytosis|Elliptocytosis]]
-* Hypochromasia
 |-
 ! align="center" style="background:#DCDCDC;" |[[Lead poisoning]]<ref name="pmid25220013">{{cite journal |vauthors=Bain BJ |title=Lead poisoning |journal=Am. J. Hematol. |volume=89 |issue=12 |pages=1141 |date=December 2014 |pmid=25220013 |doi=10.1002/ajh.23852 |url=}}</ref>
@@ Line 116: / Line 85: @@
 | align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | [[Intravascular|Hypochromic]]
+| align="center" style="background:#F5F5F5;" | [[Hypochromic anemia|Hypochromic]]
 | align="center" style="background:#F5F5F5;" | [[Microcytic anemia|Microcytic]]
 | align="center" style="background:#F5F5F5;" | Nl
@@ Line 163: / Line 132: @@
 | align="left" style="background:#F5F5F5;" |
 * Ringed [[Sideroblastic|sideroblasts]]
-|-
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hemolysis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Intrinsic/Extrinsic
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb concentration
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MCV
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |RDW
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reticulocytosis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Haptoglobin levels
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hepcidin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum iron
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum Tfr level
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |IBC
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ferritin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transferrin saturation
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specific finding on blood smear
 |-
 ! align="center" style="background:#DCDCDC;" |[[Anemia of chronic disease]]<ref name="pmid21239806">{{cite journal |vauthors=Roy CN |title=Anemia of inflammation |journal=Hematology Am Soc Hematol Educ Program |volume=2010 |issue= |pages=276–80 |date=2010 |pmid=21239806 |doi=10.1182/asheducation-2010.1.276 |url=}}</ref>
@@ Line 245: / Line 194: @@
 * [[Target cell|Target cells]]
 * Anisopoikilocytosis
-|-
-! align="center" style="background:#DCDCDC;" |[[Glucose 6 phosphate dehydrogenase deficiency|G6pd deficiency]]<ref name="pmid24372186">{{cite journal |vauthors=Luzzatto L, Seneca E |title=G6PD deficiency: a classic example of pharmacogenetics with on-going clinical implications |journal=Br. J. Haematol. |volume=164 |issue=4 |pages=469–80 |date=February 2014 |pmid=24372186 |pmc=4153881 |doi=10.1111/bjh.12665 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* Defect in [[Glucose-6-phosphate dehydrogenase|G6PD]] enzyme
-* X-Linked [[recessive]]
-| align="left" style="background:#F5F5F5;" |
-* History of using
-** [[Sulfonamide (medicine)|Sulfa drugs]]
-** [[Antimalarial drug|Antimalarials]]
-** [[Fava bean|Fava Beans]]
-* [[Infection|Infections]]
-| align="left" style="background:#F5F5F5;" |
-* [[Back pain]]
-* [[Hemoglobinuria]]
-| align="left" style="background:#F5F5F5;" |
-* [[Back pain]]
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" |Intrinsic
-| align="center" style="background:#F5F5F5;" |[[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" |[[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑ but usually causes resolution within 4-7 days
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |Nl to ↑
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="left" style="background:#F5F5F5;" |
-* [[Red blood cell|RBC]] with [[Heinz bodies]]
-* Bite [[Cell (biology)|cells]]
-* Blister [[Cell (biology)|cells]]
-*
-|-
-! align="center" style="background:#DCDCDC;" |[[Pyruvate kinase deficiency]]<ref name="pmid26087744">{{cite journal |vauthors=Grace RF, Zanella A, Neufeld EJ, Morton DH, Eber S, Yaish H, Glader B |title=Erythrocyte pyruvate kinase deficiency: 2015 status report |journal=Am. J. Hematol. |volume=90 |issue=9 |pages=825–30 |date=September 2015 |pmid=26087744 |pmc=5053227 |doi=10.1002/ajh.24088 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* [[Mutation]] in the ''[[PKLR]]'' and ''[[PKM2|PKM]]'' gene
-* [[Autosomal recessive]]
-| align="left" style="background:#F5F5F5;" |
-* [[Gallstones]]
-| align="left" style="background:#F5F5F5;" |
-* [[Hydrops fetalis]]
-* [[Neonatal hyperbilirubinemia]]
-* [[Iron overload]]
-* [[Perinatal]] complications
-| align="left" style="background:#F5F5F5;" |
-* Skin [[ulcers]]
-* [[Splenomegaly]]
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | Intrinsic
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" |
-* Prickle [[cells]]
-* Polychromatophilic [[erythrocytes]]
-|-
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hemolysis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Intrinsic/Extrinsic
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb concentration
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MCV
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |RDW
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reticulocytosis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Haptoglobin levels
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hepcidin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum iron
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum Tfr level
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |IBC
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ferritin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transferrin saturation
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specific finding on blood smear
-|-
-! align="center" style="background:#DCDCDC;" |[[Sickle-cell disease|Sickle cell anemia]]<ref name="pmid25431087">{{cite journal |vauthors=Singh PC, Ballas SK |title=Emerging drugs for sickle cell anemia |journal=Expert Opin Emerg Drugs |volume=20 |issue=1 |pages=47–61 |date=March 2015 |pmid=25431087 |doi=10.1517/14728214.2015.985587 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* Hbs [[point mutation]] causes a single [[Amino acid|amino acid]] replacement in β chain
-| align="left" style="background:#F5F5F5;" |
-* [[High altitude]]
-* Low [[Oxygen]]
-* [[Acidosis]]
-* African-American race
-* [[Parvovirus B19]] infection
-| align="left" style="background:#F5F5F5;" |
-* Painful crisis
-** [[Dactylitis]]
-** [[Priapism]]
-** [[Acute chest syndrome]]
-** [[Avascular necrosis|Avascular Necrosis]]
-** [[Stroke]]
-* [[Autosplenectomy]]
-* [[Salmonella|Salmonella osteomyelitis]]
-| align="left" style="background:#F5F5F5;" |
-* [[Dactylitis]]
-* [[Priapism]]
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | Intrinsic
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl or moderately ↑
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | Nl or moderately ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="left" style="background:#F5F5F5;" |
-* Increased [[erythropoiesis]]
-* [[Howell-Jolly bodies]]
-* [[Anisocytosis]]
-|-
-! align="center" style="background:#DCDCDC;" |HbC disease<ref name="pmid25335812">{{cite journal |vauthors=Lemonne N, Billaud M, Waltz X, Romana M, Hierso R, Etienne-Julan M, Connes P |title=Rheology of red blood cells in patients with HbC disease |journal=Clin. Hemorheol. Microcirc. |volume=61 |issue=4 |pages=571–7 |date=2016 |pmid=25335812 |doi=10.3233/CH-141906 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* Glutamic acid–to-lysine [[mutation]] in β-globin
-| align="left" style="background:#F5F5F5;" |
-* [[Gallstone]]
-| align="left" style="background:#F5F5F5;" |
-* [[Joint pains]]
-* Increased risk of [[Infection|infections]]
-| align="left" style="background:#F5F5F5;" |
-* [[Splenomegaly]]
-* [[Gallstone disease|Cholelithiasis]]
-* [[Avascular necrosis|Avascular necrosis of the femoral head]]
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | Intrinsic
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" |
-* Hemoglobin crystals inside [[RBCs]]
-* [[Target cell|Target cells]]
-|-
-! align="center" style="background:#DCDCDC;" |[[Paroxysmal nocturnal hemoglobinuria]]<ref name="pmid1402472">{{cite journal |vauthors=Bunyaratvej A, Butthep P |title=Cytometric analysis of paroxysmal nocturnal hemoglobinuria erythrocytes |journal=J Med Assoc Thai |volume=75 Suppl 1 |issue= |pages=237–42 |date=January 1992 |pmid=1402472 |doi= |url=}}</ref><ref name="pmid25553278">{{cite journal |vauthors=Kahng J, Kim Y, Kim JO, Koh K, Lee JW, Han K |title=A novel marker for screening paroxysmal nocturnal hemoglobinuria using routine complete blood count and cell population data |journal=Ann Lab Med |volume=35 |issue=1 |pages=35–40 |date=January 2015 |pmid=25553278 |pmc=4272963 |doi=10.3343/alm.2015.35.1.35 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* [[PIGA]] gene mutations
-* Impaired  synthesis of [[GPI anchor]] for [[decay-accelerating  factor]]
-| align="left" style="background:#F5F5F5;" |
-* Associated with [[aplastic anemia]]
-* [[Thrombosis]]
-| align="left" style="background:#F5F5F5;" |
-* [[Fatigue]]
-* [[Chest pain]]
-* [[Dyspnea]] on exertion
-* [[Headache]]
-| align="left" style="background:#F5F5F5;" |
-* [[Hemolysis|Chronic hemolysis]]
-* [[Hepatomegaly]]
-* [[Ascites]]
-* [[Papilledema]]
-* Skin nodules
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | Intrinsic
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | NA
-|-
-! align="center" style="background:#DCDCDC;" |[[Hereditary spherocytosis]]<ref name="pmid23664421">{{cite journal |vauthors=Da Costa L, Galimand J, Fenneteau O, Mohandas N |title=Hereditary spherocytosis, elliptocytosis, and other red cell membrane disorders |journal=Blood Rev. |volume=27 |issue=4 |pages=167–78 |date=July 2013 |pmid=23664421 |doi=10.1016/j.blre.2013.04.003 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* [[Mutations]] in [[Ankyrin]], [[Band 3]], [[Protein 4.2]], and [[spectrin]]
-| align="left" style="background:#F5F5F5;" |
-* Associated with [[parvovirus B19]]
-* [[Cholelithiasis]]
-* Megaloblastic crisis
-| align="left" style="background:#F5F5F5;" |
-* [[Aplastic crisis]]
-| align="left" style="background:#F5F5F5;" |
-* [[Splenomegaly]]
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | Intrinsic
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" |
-* Small, round [[Red blood cell|RBC]]s with less surface area and no central pallor
-|-
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hemolysis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Intrinsic/Extrinsic
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb concentration
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MCV
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |RDW
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reticulocytosis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Haptoglobin levels
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hepcidin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum iron
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum Tfr level
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |IBC
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ferritin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transferrin saturation
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specific finding on blood smear
-|-
-! align="center" style="background:#DCDCDC;" |[[Microangiopathic hemolytic anemia]]<ref name="pmid26251142">{{cite journal |vauthors=Morishita E |title=[Diagnosis and treatment of microangiopathic hemolytic anemia] |language=Japanese |journal=Rinsho Ketsueki |volume=56 |issue=7 |pages=795–806 |date=July 2015 |pmid=26251142 |doi=10.11406/rinketsu.56.795 |url=}}</ref><ref name="pmid23390027">{{cite journal |vauthors=George JN, Charania RS |title=Evaluation of patients with microangiopathic hemolytic anemia and thrombocytopenia |journal=Semin. Thromb. Hemost. |volume=39 |issue=2 |pages=153–60 |date=March 2013 |pmid=23390027 |doi=10.1055/s-0032-1333538 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" | Associated with
-* [[Disseminated intravascular coagulation|DIC]]
-* [[TTP]]
-* [[Hemolytic-uremic syndrome|HUS]]
-* [[SLE]]
-* [[HELLP syndrome]]
-* [[Hypertensive crisis|Hypertensive emergency]]
-| align="left" style="background:#F5F5F5;" |
-* [[Purpura]]
-* [[Confusion]]
-* [[Aphasia]]
-* [[Diplopia]]
-| align="left" style="background:#F5F5F5;" |
-* [[Paresthesia|Numbness]] of an arm or hand
-* [[Jaundice]]
-* [[Pallor|Pale conjunctiva]]
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | Extrinsic
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" |
-* Helmet cells
-|-
-! align="center" style="background:#DCDCDC;" |Macroangiopathic hemolytic anemia<ref name="pmid5108522">{{cite journal |vauthors=Westphal RG, Azen EA |title=Macroangiopathic hemolytic anemia due to congenital cardiovascular anomalies |journal=JAMA |volume=216 |issue=9 |pages=1477–8 |date=May 1971 |pmid=5108522 |doi= |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* [[Autoimmunity|Autoimmune]]
-| align="left" style="background:#F5F5F5;" | Associated with
-* [[Artificial heart valve|Prosthetic heart valves]]
-* [[Aortic stenosis]]
-| align="left" style="background:#F5F5F5;" |
-* [[Pallor]]
-* [[Fatigue]]
-| align="left" style="background:#F5F5F5;" |
-* Signs of [[anemia]]
-* Complications of [[hemolysis]]
-* Decreased vascular volume
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | Extrinsic
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" |
-* [[Spherocytosis|Spherocytes]] or [[Red blood cell|schistocytes]]
-|-
-! align="center" style="background:#DCDCDC;" |[[Autoimmune  hemolytic anemia]]<ref name="pmid26447931">{{cite journal |vauthors=Hill QA |title=Autoimmune hemolytic anemia |journal=Hematology |volume=20 |issue=9 |pages=553–4 |date=October 2015 |pmid=26447931 |doi=10.1179/1024533215Z.000000000401 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" | Associated with:
-* [[SLE]]
-* [[Chronic lymphocytic leukemia|CLL]]
-* [[Mycoplasma pneumonia]]
-| align="left" style="background:#F5F5F5;" |
-* Painful blue fingers and toes on exposure to cold temperature
-* [[Chest pain]]
-* [[Rigor|Chills]]
-* [[Dizziness]]
-* [[Tachycardia]]
-* [[Headache]]
-* [[Fatigue]]
-| align="left" style="background:#F5F5F5;" |
-* Painful, blue fingers and toes with cold weather
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | Extrinsic
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" |
-* [[Red blood cell|RBC]] agglutination
-|-
-! align="center" style="background:#DCDCDC;" |[[Aplastic anemia]]<ref name="pmid24424170">{{cite journal |vauthors=Dolberg OJ, Levy Y |title=Idiopathic aplastic anemia: diagnosis and classification |journal=Autoimmun Rev |volume=13 |issue=4-5 |pages=569–73 |date=2014 |pmid=24424170 |doi=10.1016/j.autrev.2014.01.014 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* Constitutive expression of Tbet
-* [[Mutation|Mutations]] in the [[perforin]] gene
-* Mutations in ''SAP'' gene
-| align="left" style="background:#F5F5F5;" |
-* Exposure to [[Radiation]]
-* Drugs like [[Benzene]], [[chloramphenicol]], [[Alkylating agent|alkylating agents]]
-* Viral infections like [[EBV]], [[HIV]], [[Hepatitis]]
-* [[Fanconi anemia]]
-* Idiopathic like [[Immune]] mediated, primary stem cell defect
-| align="left" style="background:#F5F5F5;" |
-* Symptoms based on underlying condition
-| align="left" style="background:#F5F5F5;" |
-* Short stature
-* [[Cafe-au-lait spots]]
-* Thumb defects
-* [[Radius (bone)|Radial]] defects
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |[[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" |[[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="left" style="background:#F5F5F5;" |
-* [[Pancytopenia]]
-* Fatty [[Infiltration (medical)|infiltration]]
-|-
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hemolysis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Intrinsic/Extrinsic
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb concentration
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MCV
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |RDW
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reticulocytosis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Haptoglobin levels
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hepcidin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum iron
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum Tfr level
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |IBC
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ferritin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transferrin saturation
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specific finding on blood smear
-|-
-! align="center" style="background:#DCDCDC;" |[[Folate deficiency]]<ref name="pmid25663227">{{cite journal |vauthors=Koike H, Takahashi M, Ohyama K, Hashimoto R, Kawagashira Y, Iijima M, Katsuno M, Doi H, Tanaka F, Sobue G |title=Clinicopathologic features of folate-deficiency neuropathy |journal=Neurology |volume=84 |issue=10 |pages=1026–33 |date=March 2015 |pmid=25663227 |doi=10.1212/WNL.0000000000001343 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* Impaired [[DNA]] synthesis
-| align="left" style="background:#F5F5F5;" |
-* [[Long-term effects of alcohol|Alcohol consumption]]
-* History of using drugs like [[methotrexate]], [[trimethoprim]], and [[phenytoin]]
-* Low socioeconomic groups with poor nutrition
-* Older people
-* [[Pregnancy|Pregnant]] and [[lactating]] women
-| align="left" style="background:#F5F5F5;" |
-* No neurological symptoms vs [[Vitamin B12 deficiency|B12 deficiency]]
-* [[Odinophagia|Odynophagia]]
-* [[Stomatitis|Angular stomatitis]]
-| align="left" style="background:#F5F5F5;" |
-* [[Glossitis]]
-* Signs of [[Congestive heart failure|heart failure]]
-* [[Anencephaly]] and [[spina bifida]]
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |Anisochromic
-| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="left" style="background:#F5F5F5;" |
-* [[Macrocytosis|RBC macrocytosis]]
-* [[Neutrophil|Hypersegmented neutrophils]]
-* [[Pancytopenia]] in severe cases
-*
-|-
-! align="center" style="background:#DCDCDC;" |[[Vitamin B12 deficiency]]<ref name="pmid25189324">{{cite journal |vauthors=Hunt A, Harrington D, Robinson S |title=Vitamin B12 deficiency |journal=BMJ |volume=349 |issue= |pages=g5226 |date=September 2014 |pmid=25189324 |doi= |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* Impaired [[DNA synthesis]]
-| align="left" style="background:#F5F5F5;" |
-* [[Pernicious anemia]]
-* [[Crohn's disease]]
-* [[Gastrectomy]]
-* [[Vegan|Veganism]]
-* [[Diphyllobothrium|Diphyllobothrium latum]] infection
-| align="left" style="background:#F5F5F5;" |
-* [[Psychosis]]
-* [[Insomnia]]
-* [[Depression]]
-* Cognitive slowing
-* [[Restless leg syndrome]]
-| align="left" style="background:#F5F5F5;" |
-* Neurological deficit
-* [[Myelopathy]]
-* [[Memory loss]] with reduced attention span
-* [[Nystagmus]]
-* Positive [[Romberg test|romberg sign]]
-* Positive [[Lhermitte's sign]]
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |Anisochromic
-| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="left" style="background:#F5F5F5;" |
-* [[Senile]] [[neutrophil]]
-* [[Anisocytosis]]
-* [[Ovalocytosis|Ovalocytes]]
-|-
-! align="center" style="background:#DCDCDC;" |[[Orotic aciduria]]<ref name="pmid25757096">{{cite journal |vauthors=Grohmann K, Lauffer H, Lauenstein P, Hoffmann GF, Seidlitz G |title=Hereditary orotic aciduria with epilepsy and without megaloblastic anemia |journal=Neuropediatrics |volume=46 |issue=2 |pages=123–5 |date=April 2015 |pmid=25757096 |doi=10.1055/s-0035-1547341 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* [[Autosomal recessive]]
-* Deficiency of enzyme [[Uridine monophosphate synthetase|UMPS]]
-| align="left" style="background:#F5F5F5;" |
-* Episodic [[Nausea and vomiting|vomiting]]
-* [[Rhabdomyolysis]]
-| align="left" style="background:#F5F5F5;" |
-* [[Coma]]
-* [[Gastrointestinal tract|Gastrointestinal]] manifestation
-| align="left" style="background:#F5F5F5;" |
-* Neurological manifestation
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |Anisochromic
-| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |NA
-|-
-! align="center" style="background:#DCDCDC;" |[[Fanconi anemia]]<ref name="pmid25455269">{{cite journal |vauthors=Alter BP |title=Fanconi anemia and the development of leukemia |journal=Best Pract Res Clin Haematol |volume=27 |issue=3-4 |pages=214–21 |date=2014 |pmid=25455269 |pmc=4254647 |doi=10.1016/j.beha.2014.10.002 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |
-* [[Autosomal recessive]]
-* [[X-linked recessive]]
-| align="left" style="background:#F5F5F5;" |
-* History of [[anemia]] at age 16
-| align="left" style="background:#F5F5F5;" |
-* [[Hypopigmentation]]
-* [[Café au lait spot|Cafe-au-lait patches]]
-* Radial ray anomaly
-| align="left" style="background:#F5F5F5;" |
-* Significant for bilateral short thumbs
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |Anisochromic
-| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="left" style="background:#F5F5F5;" |
-* Nl appearing [[White blood cells|WBC]], [[Red blood cell|RBC]] and [[Platelet|Platelets]]
-* But the number is greatly reduced
-|-
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hemolysis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Intrinsic/Extrinsic
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb concentration
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MCV
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |RDW
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reticulocytosis
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Haptoglobin levels
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hepcidin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum iron
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum Tfr level
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |IBC
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ferritin
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transferrin saturation
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specific finding on blood smear
-|-
-! align="center" style="background:#DCDCDC;" |[[Diamond-Blackfan anemia]]<ref name="pmid24665981">{{cite journal |vauthors=Vlachos A, Blanc L, Lipton JM |title=Diamond Blackfan anemia: a model for the translational approach to understanding human disease |journal=Expert Rev Hematol |volume=7 |issue=3 |pages=359–72 |date=June 2014 |pmid=24665981 |doi=10.1586/17474086.2014.897923 |url=}}</ref>
-| align="left" style="background:#F5F5F5;" |Mutations in:
-* ''RPL5''
-* ''RPL11''
-* ''RPL35A''
-* ''RPS7''
-* ''RPS10''
-* ''RPS17''
-* ''RPS19''
-* ''RPS24''
-* ''RPS26''
-| align="left" style="background:#F5F5F5;" |
-* Associated with [[myelodysplastic syndrome]]
-* Increased risk of [[AML]]
-| align="left" style="background:#F5F5F5;" |
-* [[Pale skin]]
-* Sleepiness
-* [[Murmur|Heart murmurs]]
-| align="left" style="background:#F5F5F5;" |
-* Triphalangeal  thumbs
-* [[Short stature]]
-* [[Microcephaly]]
-* [[Hypertelorism]]
-* [[Ptosis]]
-* [[Micrognathia]]
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |Anisochromic
-| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |NA
-|-
-! align="center" style="background:#DCDCDC;" |[[Infection|Infections]]<ref name="pmid23324217">{{cite journal |vauthors=Bustinduy AL, Parraga IM, Thomas CL, Mungai PL, Mutuku F, Muchiri EM, Kitron U, King CH |title=Impact of polyparasitic infections on anemia and undernutrition among Kenyan children living in a Schistosoma haematobium-endemic area |journal=Am. J. Trop. Med. Hyg. |volume=88 |issue=3 |pages=433–40 |date=March 2013 |pmid=23324217 |pmc=3592521 |doi=10.4269/ajtmh.12-0552 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" | Associated with
-* [[Malaria]]
-* [[Babesia]]
-| align="left" style="background:#F5F5F5;" |
-* [[Fever]]
-| align="left" style="background:#F5F5F5;" |
-* [[Fever]]
-* Signs of [[shock]]
-* [[Headache]]
-| align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | Extrinsic
-| align="center" style="background:#F5F5F5;" | [[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" | [[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↑
-| align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | −
-| align="left" style="background:#F5F5F5;" |
-* [[Trophozoite]]
-* Maltese crosses
-|-
-! align="center" style="background:#DCDCDC;" |[[Chronic renal failure|Chronic kidney disease]]<ref name="pmid26030647">{{cite journal |vauthors=Drawz P, Rahman M |title=Chronic kidney disease |journal=Ann. Intern. Med. |volume=162 |issue=11 |pages=ITC1–16 |date=June 2015 |pmid=26030647 |doi=10.7326/AITC201506020 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" |−
-| align="left" style="background:#F5F5F5;" |
-* [[Pericarditis]]
-* [[Encephalopathy]]
-* [[Incontinence|Rectal incontinence]]
-* Decreased [[libido]]
-* [[Restless legs syndrome|Restless leg syndrome]]
-| align="left" style="background:#F5F5F5;" |
-* [[Polyuria]]
-* [[Hematuria]]
-* [[Edema]]
-| align="left" style="background:#F5F5F5;" |
-* [[Hypertension]]
-| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |[[Normochromic anemia|Normochromic]]
-| align="center" style="background:#F5F5F5;" |[[Normocytic anemia|Normocytic]]
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |Nl/↑
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |Nl
-|-
-! align="center" style="background:#DCDCDC;" |[[Hepato-biliary diseases|Liver disease]]<ref name="pmid23953338">{{cite journal |vauthors=Marks PW |title=Hematologic manifestations of liver disease |journal=Semin. Hematol. |volume=50 |issue=3 |pages=216–21 |date=July 2013 |pmid=23953338 |doi=10.1053/j.seminhematol.2013.06.003 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" |−
-| align="left" style="background:#F5F5F5;" |
-* [[Hepatitis]]
-* Binge drinking
-* Gall bladder disease
-| align="left" style="background:#F5F5F5;" |
-* [[Jaundice]]
-* [[Abdominal pain]]
-* [[Itchy skin]]
-| align="left" style="background:#F5F5F5;" |
-* [[Ascites]]
-* Right upper quadrant pain
-* [[Hepatomegaly]]
-* [[Edema|Swelling]] in the legs
-* [[Ankle swelling]]
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |Anisochromic
-| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="left" style="background:#F5F5F5;" |
-* [[Macrocyte|Round macrocytes]]
-* [[Macrocyte|Target macrocytes]]
-|-
-! align="center" style="background:#DCDCDC;" |[[Alcoholism]]<ref name="pmid24588059">{{cite journal |vauthors=Yokoyama A, Yokoyama T, Brooks PJ, Mizukami T, Matsui T, Kimura M, Matsushita S, Higuchi S, Maruyama K |title=Macrocytosis, macrocytic anemia, and genetic polymorphisms of alcohol dehydrogenase-1B and aldehyde dehydrogenase-2 in Japanese alcoholic men |journal=Alcohol. Clin. Exp. Res. |volume=38 |issue=5 |pages=1237–46 |date=May 2014 |pmid=24588059 |doi=10.1111/acer.12372 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" |−
-| align="left" style="background:#F5F5F5;" |
-* History of increased [[Effects of alcohol on the body|alcohol intake]]
-* [[Folic acid deficiency]]
-| align="left" style="background:#F5F5F5;" |
-* [[Memory impairment]]
-* [[Nausea]]
-* [[Sweating]]
-| align="left" style="background:#F5F5F5;" |
-* Truncal [[obesity]]
-* [[Asterixis]]
-* [[Encephalopathy]]
-* [[Spider angiomas]]
-* [[Hematemesis]]
-* [[Gynecomastia]]
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |−
-| align="center" style="background:#F5F5F5;" |Anisochromic
-| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↓
-| align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" |↑
-| align="left" style="background:#F5F5F5;" |
-* [[Macrocyte|Oval macrocytes]]
-* [[Neutrophil|Hypersegmented neutrophils]]
 |-
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease