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Classification of anemia

Functional classification:
Hypoproliferative destruction (infective
Clinical classification:
Causes of anemia (blood loss, IDA, hemolysis).
Quantitative classification:
Blood cell indices (MCV, MCH, MCHC).
Reticulocytes count.
Red cell indices
MCV (mean corpuscular volume)
The average volume of RBC
= 10 (fl)
RBC count (m/L)
e.g. Hct= 40%
RBC=5.0 (m /L)
MCV= 40/5.0 10 = 80 fl
NR= 80-96 fl
MCH (mean corpuscular hemoglobin)
The average content of Hb in average RBC.
It is directly proportional to the amount of Hb
and RBC size.

MCH = 10 (pg)
RBC count (m/L)

e.g. Hb = 14 g/dl
RBC = 4 (m/L)

MCH= 14/4 10
= 35 pg

NR= 27-32 pg
MCHC (mean corpuscular hemoglobin
Express the average concentration of
hemoglobin per unit volume of RBC.
It defined as the ratio of the weight of
hemoglobin to volume of RBC.
Hb (g/dl)
MCHC= 100 (%)
Hct (%)

e.g. Hb = 14 g/dl
Hct = 45 %

MCHC 14/45 100 = 31%

NR= 32-36%
Symptoms of Anemia

Normal or High Hemoglobin/Hematocrit

Check other
Causes of symptoms
e.g. Cardiac Low
Pulmonary RBC indices

MCV < 80 MCV=80-96 MCV > 98

MCHC < 32
History of acute blood loss
B12 and folate
Serum iron and Total Auto immune Hemolytic anemia
Iron binding capacity Anemia of chronic Diseases levels
of Ferritin Anemia of infection

Low Iron Normal High Iron Low B12 Low folate High or Normal

IDA, chronic Hb BM exam PA, GI Folate MPD

diseases, Renal electrophoresis For problems malnutrition Liver Disease
diseases for Thala. Sideroblastic Severe GI problems
anemia malnutrition. Liver disease
Normal red cell morphology
Hypochromic Hyperchromic

Macrocytic Microcytic
Target cells Stomatocytes

Poikiolocytosis Sickle cells Acanthocytes

Ovalocyte Nucleated RBC