🩸 Hematology & Oncology🟡 High-yieldAnaemia Classification

Morphological Classification of Anaemia

A framework that sorts anaemia by red-cell size (the MCV) into microcytic, normocytic and macrocytic, pointing to the likely cause.

Key points

Anaemia is a fall in haemoglobin below the normal range for age and sex; classifying it by red-cell size narrows the cause quickly.
Microcytic (low MCV) anaemia is typically iron deficiency, thalassaemia or sideroblastic anaemia, and sometimes anaemia of chronic disease.
Normocytic (normal MCV) anaemia includes acute blood loss, haemolysis, anaemia of chronic disease and marrow failure.
Macrocytic (high MCV) anaemia divides into megaloblastic, from vitamin B12 or folate deficiency, and non-megaloblastic, from alcohol, liver disease or hypothyroidism.
The reticulocyte count separates a responding marrow (high, as after haemolysis or blood loss) from a hypoproliferative one (low, as in deficiency, marrow failure, chronic kidney disease, inflammation or endocrine disease).
Megaloblastic anaemia shows large oval red cells and hypersegmented neutrophils on the film, because DNA synthesis is impaired while the cytoplasm keeps growing.

Sort by size first — small means iron and thalassaemia, large means B12 and folate, normal means bleed, break-down or marrow.

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🩸 Hematology & Oncology🟡 High-yieldAnaemia Classification

A framework that sorts anaemia by red-cell size (the MCV) into microcytic, normocytic and macrocytic, pointing to the likely cause.

Anaemia is a fall in haemoglobin below the normal range for age and sex; classifying it by red-cell size narrows the cause quickly.
Microcytic (low MCV) anaemia is typically iron deficiency, thalassaemia or sideroblastic anaemia, and sometimes anaemia of chronic disease.
Normocytic (normal MCV) anaemia includes acute blood loss, haemolysis, anaemia of chronic disease and marrow failure.
Macrocytic (high MCV) anaemia divides into megaloblastic, from vitamin B12 or folate deficiency, and non-megaloblastic, from alcohol, liver disease or hypothyroidism.
The reticulocyte count separates a responding marrow (high, as after haemolysis or blood loss) from a hypoproliferative one (low, as in deficiency, marrow failure, chronic kidney disease, inflammation or endocrine disease).
Megaloblastic anaemia shows large oval red cells and hypersegmented neutrophils on the film, because DNA synthesis is impaired while the cytoplasm keeps growing.

Sort by size first — small means iron and thalassaemia, large means B12 and folate, normal means bleed, break-down or marrow.