Anemia is defined when hemoglobin is less than 13.5 g/dL in men, less than 12 g/dL in women, or less than 11 g/dL in pregnant women.
Hematocrit = 3 times the hemoglobin
Mean corpuscular volume (CMV) = hematocrit divided by erythrocyte number (normal value = 80-100)
If the mean cell volume is less than 80 (microcytic anemia)
If the average pellet size is between 80-100, then this is normal
If the mean corpuscular volume is greater than 100, this means megaloblastic anemia
Mean corpuscular hemoglobin (MCH) = hemoglobin divided by erythrocyte number = 27-34
CHC = hemoglobin split hematocrit = 34-36%
At altitude, the first thing we think of is hereditary spherocytosis
Red blood cell distribution capacity (RDW) is the difference in the size of red blood cells and their increase in the peripheral blood called anisocytosis.
It is high in iron deficiency anemia and normal in thalassemia carriers
Also in cases of remission we look at the number of platelets and leukocytes and investigate whether there is a disease that affects this series
Classification of anemia by red blood cell size
small cells (mcv < 80)
Anemia due to iron deficiency
Anemia is a chronic disease
thalassemia
Iron-blastic anemia
Large Cells (mcv > 100 fl)
Megaloblastic anemia: B12 and folate deficiency and myelodysplastic syndrome
Non-megaloblastic megaloblastic anemia: liver disease - anemia of glandular origin - bone marrow disease (nonfactory anemia - alcoholism)
normocytic anemia (mcv = 80-100)
All cases of anemia in their early stages
Two thirds of chronic diseases
Erythropoietin deficiency
Liver diseases
endocrine anemia
hemolytic anemia
bone marrow diseases
Aplastic Anemia
alcoholic
Peripheral smear findings and their equivalents
Microcytosis (red blood cells smaller than normal. Iron deficiency anemia, chronic disease anemia, thalassemia, and sideroblastic anaemia)
Macrocytosis (red blood cells larger than normal, for example: vitamin B12 deficiency, folate deficiency, myelodysplastic syndrome, liver disease, endocrine anemia, hemolytic anemia, bone marrow disease (myelodysplastic anemia, aplastic anemia) and alcoholism)
Hypochromia (the empty pale area in the middle of the erythrocyte is larger than 1/3. It is mostly associated with small cells. Indicates a disorder of hemoglobin synthesis)
Target cells (It is an abnormal deposition of hemoglobin in the central portion of red blood cells. There is a pale halo, a Mexican hat-shaped image, often seen in thalassemia. Chronic disease and sickle cell anemia)
Anisocytosis (indicates the presence of red blood cells of different sizes. It appears in most cases of anemia)
Poikilocytosis differs in erythrocyte shapes (seen in most cases of anemia)
Polychromasia (as in the case of reticulocytosis)
Burr cells (as in cases of pyruvate deficiency)
Acanthocytes (as in beta-lipoprotein deficiency and chronic liver disease)
Heinz bodies (occurs in G6PD deficiency)
Howell-Jolly particles (they are remnants of nuclear material that cannot be expelled during maturation and remain in red blood cells, seen in splenectomy, aneurysms, and megaloblastic anaemia)
pappenheimer bodies (it is an iron-protein complex in red blood cells, seen in sideroblastic anemia and after splenectomy)
Hypersegmented neutrophils (associated with vitamin B12 and folate deficiency)
Nucleated Erythrocytes (appearance of normal erythrocytes in the periphery. It can be seen in cases of increased erythropoiesis, such as acute hemolysis and severe blood loss. It may also develop due to leukemia and tumor infiltration into the bone marrow)
Peripheral smear image of bone marrow (occurs in myelofibrosis and bone marrow infiltrates)
Reticulocytes
Small erythrocytes in the earlier stage of mature erythrocytes are called reticulocytes (larger than mature erythrocytes)
They lost their nucleus, but they have RNA and can synthesize hemoglobin
In the peripheral smear, they are seen as large, basal cells with greyish multicolored structures
Corrected reticulocyte count = reticulocytes x hematocrit / 45 or reticulocytes x hemoglobin / 15
Reticulocytosis
It means more than 2% where there is an increase in demolition and synthesis
the reasons
hemolytic anemia
severe bleeding
On the 4-7th day for the treatment of iron deficiency anemia
On day 3-4 for the treatment of vitamin B12 deficiency anemia
Reticulocytopenia
means less than 0.5%
the reasons
aplastic anemia
leukemia
iron deficiency
Deficiency of B12 and folic acid
The first disease to consider in the presence of reticulocytosis is hemolytic anemia.
The first disease to consider in the presence of retinal leukopenia is aplastic anemia.
Hematocrit = 3 times the hemoglobin
Mean corpuscular volume (CMV) = hematocrit divided by erythrocyte number (normal value = 80-100)
If the mean cell volume is less than 80 (microcytic anemia)
If the average pellet size is between 80-100, then this is normal
If the mean corpuscular volume is greater than 100, this means megaloblastic anemia
Mean corpuscular hemoglobin (MCH) = hemoglobin divided by erythrocyte number = 27-34
CHC = hemoglobin split hematocrit = 34-36%
At altitude, the first thing we think of is hereditary spherocytosis
Red blood cell distribution capacity (RDW) is the difference in the size of red blood cells and their increase in the peripheral blood called anisocytosis.
It is high in iron deficiency anemia and normal in thalassemia carriers
Also in cases of remission we look at the number of platelets and leukocytes and investigate whether there is a disease that affects this series
Classification of anemia by red blood cell size
small cells (mcv < 80)
Anemia due to iron deficiency
Anemia is a chronic disease
thalassemia
Iron-blastic anemia
Large Cells (mcv > 100 fl)
Megaloblastic anemia: B12 and folate deficiency and myelodysplastic syndrome
Non-megaloblastic megaloblastic anemia: liver disease - anemia of glandular origin - bone marrow disease (nonfactory anemia - alcoholism)
normocytic anemia (mcv = 80-100)
All cases of anemia in their early stages
Two thirds of chronic diseases
Erythropoietin deficiency
Liver diseases
endocrine anemia
hemolytic anemia
bone marrow diseases
Aplastic Anemia
alcoholic
Peripheral smear findings and their equivalents
Microcytosis (red blood cells smaller than normal. Iron deficiency anemia, chronic disease anemia, thalassemia, and sideroblastic anaemia)
Macrocytosis (red blood cells larger than normal, for example: vitamin B12 deficiency, folate deficiency, myelodysplastic syndrome, liver disease, endocrine anemia, hemolytic anemia, bone marrow disease (myelodysplastic anemia, aplastic anemia) and alcoholism)
Hypochromia (the empty pale area in the middle of the erythrocyte is larger than 1/3. It is mostly associated with small cells. Indicates a disorder of hemoglobin synthesis)
Target cells (It is an abnormal deposition of hemoglobin in the central portion of red blood cells. There is a pale halo, a Mexican hat-shaped image, often seen in thalassemia. Chronic disease and sickle cell anemia)
Anisocytosis (indicates the presence of red blood cells of different sizes. It appears in most cases of anemia)
Poikilocytosis differs in erythrocyte shapes (seen in most cases of anemia)
Polychromasia (as in the case of reticulocytosis)
Burr cells (as in cases of pyruvate deficiency)
Acanthocytes (as in beta-lipoprotein deficiency and chronic liver disease)
Heinz bodies (occurs in G6PD deficiency)
Howell-Jolly particles (they are remnants of nuclear material that cannot be expelled during maturation and remain in red blood cells, seen in splenectomy, aneurysms, and megaloblastic anaemia)
pappenheimer bodies (it is an iron-protein complex in red blood cells, seen in sideroblastic anemia and after splenectomy)
Hypersegmented neutrophils (associated with vitamin B12 and folate deficiency)
Nucleated Erythrocytes (appearance of normal erythrocytes in the periphery. It can be seen in cases of increased erythropoiesis, such as acute hemolysis and severe blood loss. It may also develop due to leukemia and tumor infiltration into the bone marrow)
Peripheral smear image of bone marrow (occurs in myelofibrosis and bone marrow infiltrates)
Reticulocytes
Small erythrocytes in the earlier stage of mature erythrocytes are called reticulocytes (larger than mature erythrocytes)
They lost their nucleus, but they have RNA and can synthesize hemoglobin
In the peripheral smear, they are seen as large, basal cells with greyish multicolored structures
Corrected reticulocyte count = reticulocytes x hematocrit / 45 or reticulocytes x hemoglobin / 15
Reticulocytosis
It means more than 2% where there is an increase in demolition and synthesis
the reasons
hemolytic anemia
severe bleeding
On the 4-7th day for the treatment of iron deficiency anemia
On day 3-4 for the treatment of vitamin B12 deficiency anemia
Reticulocytopenia
means less than 0.5%
the reasons
aplastic anemia
leukemia
iron deficiency
Deficiency of B12 and folic acid
The first disease to consider in the presence of reticulocytosis is hemolytic anemia.
The first disease to consider in the presence of retinal leukopenia is aplastic anemia.