Abstract
This chapter discusses most anemias, especially those associated with significant bone marrow changes. Anemia, a decline in blood hemoglobin (Hb) level, is caused by three major mechanisms: blood loss, inefficient erythropoiesis, and increased red blood cell (RBC) destruction. These mechanisms are often associated with certain morphologic features reflecting the size or the Hb content of the erythrocytes. Four RBC indices are measured by automated hematology instruments in clinical laboratories. These indices correlate with the size, hemoglobin content, and degree of anisocytosis in the RBCs. They include: mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); mean corpuscular hemoglobin concentration; red cell distribution width (RDW) indicates the degree of anisocytosis. Biochemical analyses such as measurement of serum iron, iron-binding capacity, ferritin, folate, and vitamin B12 levels, RBC enzyme assays, and Hb electrophoresis provide valuable information regarding the cause of anemia. Molecular genetic studies add additional dimensions to the understanding, classification, and treatment of certain anemias, particularly the hereditary variants. Routine examination of the peripheral blood plays a key role in the diagnosis and classiffication of anemias. It provides basic information regarding RBC counts, morphology and indices, Hb and hematocrit levels.
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