What is the conclusion of anemia?

Iron-deficiency anemia

- If microcytic hypochromic anemia is present and responds to iron therapy, iron-deficiency anemia is assumed.

- In some circumstances, bone marrow examination or a serum iron level may be necessary.

Vitamin B12 or folate deficiency

- If macrocytic anemia unresponsive to iron therapy is present, the serum levels of vitamin B12 and folate should be measured.

- Bone marrow examination should be done if B12 or folate deficiency is suspected and levels of these vitamins are normal or equivocal.

Hemoglobinopathies and thalassemias

- Hb electrophoresis to identify hemoglobinopathies and thalassemias is indicated in patients with microcytic hypochromic anemia that does not respond to iron therapy and in patients with macrocytosis or mild anemia unexplained by other disorders.

- DNA sequencing may be necessary to distinguish beta-thalassemia trait from alpha-thalassemia trait and to identify rare mutations.

Aplastic anemia and myelodysplasia

- Bone marrow examination is necessary if peripheral blood counts show pancytopenia or marked bicytopenia.

Diagnosis confirmed

- Once the diagnosis of anemia has been confirmed, tests are done to determine the etiology.

- If the diagnosis remains unclear after initial testing, further specialized tests, including genetic studies, may need to be done.

Treatment

- Treatment depends on the specific etiology.