Anemia-diagnostics
Description | Basic evaluations (screening): Blood: Full blood count, ESR or CRP, ferritin, haptoglobin, reticulocytes, direct and indirect Coombs-test, folic acid, vitamin B12, methylmalonic acid, hemoglobin-electrophoresis Urine: Urine status and sedimentation Stool: Investigation for blood (hemoccult test) Analysis as per clinical suspicion: Iron-deficiency anemia: Iron, ferritin, transferrin, urine status, hemoccult, hemoglobin-electrophoresis, substituted anemia due to vitamin-B12-deficiency. In case of unclear transaminase-increase, also consider non-classical type of Celiac’s disease/sprue (see there). Hemolytic anemia: Haptoglobin, LDH, reticulocytes, bilirubin, urine status, direct and indirect Coombs-test, cold agglutinin, osmotic resistance, erythrocyte-enzymes (G-6-PDH, pyruvatkinase and others), hemoglobin-electrophoresis, MetHb, ANA, Ham’s test Pernicious anemia: Folic acid, vitamin B12, methylmalonic acid, intrinsic-factor-antibodies (60 %), parietal (or border-) cell antibodies (80 %), haptoglobin, LDH, reticulocytes, bilirubin, CDT, stool for fish tapeworm eggs, TSH, thyroid antibodies, vitamin B12-uptake-problems caused by medication. Please refer to sections “pancreatitis and Zollinger-Ellison-syndrome” Sideroblastic anemia: ESR or CRP, iron, ferritin, haptoglobin, porphyrine in the urine, lead (EDTA-blood), vitamin-B6, CDT, bone marrow cytology- and histology Tumor- and infection anemia: ESR or CRP, blood in the stool, transferrin, ferritin, HIV-test (consent required), tbc-diagnostic Hereditary spherocytosis: Haptoglobin, LDH, reticulocytes, bilirubin, osmotic resistance, ESR Erythrocyte enzyme defects: Haptoglobin, LDH, reticulocytes, bilirubin, erythrocyte-enzymes (glucose-6-phosphatdehydrogenase, pyruvate kinase and others) Please refer to section “erythrocyte enzymes” (analysis index) Hemoglobinopathy: Hemoglobin-electrophoresis, haptoglobin, LDH, reticulocytes, bilirubin, ferritin Paroxysmal nocturnal hemoglobinuria: PNH-diagnostics, evidence of cell membrane defect by flow cytometry, haptoglobin, LDH, reticulocytes, bilirubin, ferritin Aplastic anemia: Ham’s test, bone marrow cytology- and histology, pathogen evidence and infection serology (meningococcus, parvovirus B19, CMV, EBV and others), medication anamnesis- or screening from urine MTHFR-polymorphism: In hyperhomocysteine-anemia, evaluation of MTHFR-polymorphism Please also refer to sections “reticulocytes, table DD of anemia (analysis index) |
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