Overview
Comparison reference for Module 10, classification and approach lessons teach algorithms once; Library owns lookup tables.
Classification
| Type | MCV | Reticulocytes | Smear clues | Key chemistry | Associations (not exclusive) |
|---|---|---|---|---|---|
| Iron deficiency | Low | Low | Microcytes, pencil cells, ↑ RDW | ↓ ferritin*, ↓ iron, ↑ TIBC | Blood loss, malabsorption |
| ACI | Normal/low | Low | Often nonspecific | ↓ iron, normal/↑ ferritin | Inflammation, chronic infection |
| B₁₂ deficiency | High | Low | Macro-ovalocytes, hypersegmented PMNs | ↓ B₁₂, ↑ MMA | Pernicious anemia, malabsorption |
| Folate deficiency | High | Low | Macro-ovalocytes | ↓ folate, normal MMA | Alcohol, poor intake, drugs |
| Hemolytic (overview) | Normal/high | High | Spherocytes, schistocytes, polychromasia | ↓ haptoglobin, ↑ LDH, ↑ indirect bili | Many subtypes, see disease lessons |
| Hereditary spherocytosis | Normal | High | Spherocytes, DAT negative | Hemolysis panel positive | Membrane defect |
| G6PD deficiency | Normal | High (episodic) | Bite cells, Heinz bodies (special stain) | Hemolysis during crisis | Oxidative triggers |
| AIHA | Normal | High | Spherocytes, DAT positive | Hemolysis panel positive | Warm/cold antibody subtypes |
| Aplastic anemia | Normal | Low | Normocytic, pancytopenia | Marrow hypocellular on biopsy | Marrow failure |
| Renal anemia | Normal | Low | Burr cells possible | ↑ creatinine, iron studies per dialysis protocol | EPO deficiency pattern |
Morphologic Features
Smear terms defined in Module 7 rbc-morphology-glossary, link not repeat.
Laboratory Characteristics
- *Ferritin interpret with inflammation, acute-phase reactant
Reference Intervals
All intervals institutional.
Clinical and Laboratory Significance
Patterns suggest differentials, confirmatory testing clinician-directed.
Differential Considerations
Dual pathology common, e.g., ACI + iron deficiency, transfusion effect.
Comparison Tables
| Microcytic comparison | RDW | RBC count | Ferritin | Iron/TIBC |
|---|---|---|---|---|
| Iron deficiency | Often ↑ | Low/normal | Low (no inflammation) | ↓ iron, ↑ TIBC |
| Thalassemia trait | Normal | Often ↑ for anemia degree | Normal | Normal iron studies |
| ACI | Normal | Low/normal | Normal/↑ | ↓ iron, ↓ saturation |
Classification Frameworks
Laboratory Notes
- Compare related entries in Laboratory Library for side-by-side differentiators.
References
Authoritative textbooks, guidelines, and reviews supporting this reference entry. Verify reference intervals, critical limits, and reflex criteria against institutional protocols and current guideline editions.
Textbooks
- McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Elsevier; 2021.
- Rodak BF, Carr JH. Rodak's Hematology: Clinical Principles and Applications. 6th ed. Elsevier; 2020.
- McKenzie SB, Williams JL. Clinical Laboratory Hematology. 4th ed. Pearson; 2022.
- Hoffbrand AV, Moss PAH, Pettit JE. Essential Haematology. 8th ed. Wiley-Blackwell; 2019.
- Bain BJ. Blood Cells: A Practical Guide. 5th ed. Wiley-Blackwell; 2015.
CLSI and Professional Guidelines
- Clinical and Laboratory Standards Institute. Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Standard. CLSI document EP28-A3c. CLSI; 2010.
- Clinical and Laboratory Standards Institute. Reference and Selected Performance Standards for the Automated Complete Blood Cell Count (CBC). CLSI document H26-A2. CLSI; 2010.
WHO Publications
- World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. WHO/NMH/NHD/MNM/11.1. Geneva: WHO; 2011.
Frequently Asked Questions
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