Anaemia: Approach to diagnosis

Abstract

Anaemia is defined as a condition in which the number of red cells or their oxygen-carrying capacity is insufficient to meet physiological needs. It is the most common disorder globally and one of the conditions that general practitioners most frequently encounter. In the World Health Organization global database, anaemia is estimated to affect 1.6 billion people. As anaemia manifests in a wide range of conditions, it is important to embrace a structured diagnostic approach. The recommended approach set out in this article incorporates clinical and patho physiological considerations, red cell characteristics, and bone marrow activity. In this issue of CME, the first of two parts on anaemia, the causes of anaemia related specifically to decreased red cell production are discussed.

An approach to anaemia diagnosis – concerns in primary care

“…To the Editor: The approach to the diagnosis of anaemia [1] is a welcome addition to management of a common problem. A more nuanced approach may be warranted in primary care, where iron deficiency anaemia (IDA) [2] and anaemia of chronic disease (ACD) are common.…”

“…The diagnostic algorithm [1] reflects a contemporary morphological approach to anaemia utilising the reticulocyte response and mean corpuscular volume (MCV) as the starting point for evaluation. [7] Additionally, Alli et al [1] propose that a blood film be done on all patients, but provide no evidence to support the diagnostic yield of this approach.…”

“…[7] Additionally, Alli et al [1] propose that a blood film be done on all patients, but provide no evidence to support the diagnostic yield of this approach. In their algorithm for investigation of anaemia in HIV infection in southern Africa, Van den Berg et al [8] do not advocate a blood film as routine.…”

Laboratory Approach to Anemia

“…Hence, morphological classiication serves to support the diagnosis and indirectly treatment in connection with the laboratory and clinic. The major limitation of such a classiication is that it tells nothing about the etiology or reason for the anemia [5].…”

An approach to anaemia diagnosis – concerns in primary care

“…The CME focus [2] was on the approach to diagnosis in patients with anaemia, and so endeavoured to cover as wide a spectrum of causes as possible. As clarified in the preceding editorial, [3] detailed discussion on any particular cause/s was beyond the scope of the CME.…”