Data Interpretation - Anaemias

Data Interpretation

·        Pregnancy ® ­Fe requirements and ­fibrinogen (® ­ESR)

·        If mild microcytic anaemia and normal ferritin it‟s not iron: check either Thalassaemia or anaemia of chronic disease

·        Ferritin is an acute phase protein. It will be raised in chronic disease. So if there is chronic inflammation and a low-normal ferritin, the underlying ferritin is likely to be below normal

·        Mildly ­MCV could be because of ­reticulocytes ® check haemolysis

·        Haemolysis tests:

o   ­Production: reticulocytes, blood film

o   ­Breakdown: Hb and Hatoglobins (binding protein for haem – used up in haemolysis ® would fall)

o   Combes test: is there antibody on the RBC

o   If Fe in urine (Urine haemosiderin) then intravascular haemolysis (not spleen – which is extravascular). E.g. aortic value replacement ® haemodynamic/shear stress from turbulent flow