HCT 38 - 48 LOW DIFFERENTIAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS FOR ANEMIA

Decreased Production (Low Reticulocyte Index)

     Microcytic

          Iron Deficiency Anemia

          Thalassemia

          Sideroblastic Anemia

          Lead Intoxication

          Anemia of Chronic Disease 

          Copper Deficiency

               Zinc Toxicity 

     Normocytic

          Anemia of Chronic Disease

          Malignancies

          Hypothyroidism

          Aplastic Anemia

          Pure Red Blood Cell Aplasia

         Diamond-Blackfan Anemia

          Fanconi's Anemia 

          Parvovirus B19 

          Chronic Renal Failure

          Myeloid Metaplasia with Myelofibrosis

          Multiple Myeloma

          Ribavirin Therapy 

          Copper Deficiency 

     Macrocytic

          Oval Macrocytosis 

               B12 Deficiency Anemia

               Folate Deficiency Anemia

               Myelofibrosis 

               Myelodysplastic Syndromes

                    Refractory Anemia

                         Refractory Anemia with Ringed Sideroblasts

                         Refractory Anemia without Ringed Sideroblasts 

                    Refractory Cytopenias and Multilineage Dysplasia

                    Refractory Anemia with Excess of Type 1 Myeloblasts

                    Refractory Anemia with Excess of Type 2 Myeloblasts

                    Myelodysplastic Syndrome with Isolated Deletion of 5q

                    Unclassified Myelodysplastic Syndrome  

          Round Macrocytosis

               Liver Disease

               Alcoholism

               Chemotherapeutic Agents

               Copper Deficiency

               Preleukemia

               Medications

Increased Peripheral Destruction or Loss (Elevated or Appropriate Reticulocyte Index)

      Hemorrhage (Normal Indirect Bilirubin and LDH)

     Hemolysis (Elevated Indirect Bilirubin and LDH)

          Intravascular

               Hemolytic Transfusion Reaction

               Malaria

               Snake Bite 

               Glucose-6-Phosphate Dehydrogenase Deficiency

               Paroxysmal Nocturnal Hemoglobinuria

               Hypophosphatemia 

          Extravascular

               Hypersplenism

               Hereditary Spherocytosis

               Pyruvate Kinase Deficiency

               Wilsons Disease

               Disseminated Intravascular Coagulation

               Hemolytic Uremic Syndrome

               Thrombotic Thrombocytopenic Purpura