Anemia is defined as a too low oxygen-carrying capacity of the red blood cells. Investigation and diagnosis of the condition usually focuses on the patient’s red blood cell count and associated parameters such as hemoglobin (HGB), hematocrit (HCT), red blood cell distribution width (RDW), mean cell volume (MCV), mean cell hemoglobin concentration (MCHC), and reticulocytes (RETICS). However, to set the right classification, regenerative or non-regenerative, and find the underlying cause, further testing and examinations are needed.
Regenerative anemia is often caused by platelet (PLT) disorders, trauma, surgery, infections, or immune-mediated diseases, external factors that create a blood loss for the patient. Causes of non-regenerative anemia are instead linked to conditions affecting the production of blood cells, such as inflammatory diseases, nutritional deficiencies related to endocrine or metabolic diseases.
During an anemia investigation, a complete blood count (CBC), followed by a manual smear, is usually the first step. Depending on the patient’s symptoms, anamnesis, and CBC results, other tests are thereafter performed. Such tests may include a PLT count, together with the total plasma protein (TP); a biochemistry profile, including endocrine testing (for metabolic/endocrine disturbances), which focuses on kidney, liver, and thyroid gland; as well as other specific tests.
In summary, the combination of hematology analysis and clinical chemistry analysis provide important input for the proper diagnosis and treatment of anemia.