Laboratory Sickle cell disease Thalassemia Iron Megaloblastic Chronic ITP Aplastic

findings deficiency anemia anemia

anemia
Peripheral Blood
Hemoglobin Decreased Markedly Decreased Decreased - Decreased
reduced
Hematocrit Decreased Markedly Decreased Decreased - -
reduced
Red Cell Indices:
MCH - Decreased Decreased Increased - -
MCHC - Decreased Decreased Increased - -
RDW - - Increased, - - -
Earliest sign
of iron
deficiency
Others Reticulocyte Count: RBC Count: Reticulocyte Reticulocyte Platelet Packed
Increased Increased Count: low for Count: count: volume:
ESR: /normal the degree of Normal or low Markedly Decreased
Decreased Reticulocyte anemia reduced Reticulocyte
Count: count:
Increased Markedly
decreased
Peripheral Smear
RBCs: Normocytic Microcytic Microcytic Egg-Shaped Chronic Pancytopenia
normochromic to hypochromic and macro- blood loss , ,
mildly hypochromic, anemia, hypochromic, ovalocytes, lead to Normocytic
Anisopoikilocytosis, Target cells, Moderate Lack the central microcytic normochromi
Sickle cell, Basophilic anisocytosis pallor, hypochrom c anemia
Target cells, stippling, and anisopoikilocyto ic anemia
ovalocytes, Nucleated red poikilocytosis, sis,
polychromatophilia, cell precursors Severe – Basophilic
Howell jolly bodies Ring/pessary stippling,
cells cabot ring and
Howell jolly
bodies
WBCs Mildly increased Leukocytosis Normal; WBC count Normal Pancytopenia
with shift to left with mild left eosinophilia decreased, ,
shift in hook worm Hypersegmente Neutrophils
infestations d neutrophils markedly
diminished
Platelets Mildly increased Normal Normal Decreased Markedly Pancytopenia
reduced, ,
Abnormally Decreased
large sized
platelets
Bone Marrow
Cellularity Hypercellular Markedly Moderately Markedly Hypercellul Marrow
hypercellular hypercellular hypercellular ar aplasia (bone
marrow
biopsy)
 Markedly
hypocellular
M:E ratio - 1:1 to 1:5 2:1 to 1:2 1:1 to - -
ratio 1:6(Normal: 2:1
to 4:6)
Erythropoiesis Compensatory Normoblastic Micronormobl Megaloblastic Prolonged -
normoblastic with marked astic type bleeding
erythroid erythroid maturation *Megaloblasts lead to
hyperplasia hyperplasia * Ineffective normoblast
erythropoiesis ic erythroid
hyperplasia
, Constant
bleeding to
iron
deficiency
and
micronorm
oblastic
erythroid
hyperplasia
Myelopoiesis Normal Normal Normal *Myeloid cells Normal -
adequate in
number
*Giant
metamyelocytes
and band forms
Megakaryopoiesis Normal Normal Normal Normal or Moderate -
increased in increase in
number number of
both
immature
and mature
forms of
megakaryo
cytes,Imma
ture
megakaryo
cytes
predomina
te large
non
lobulated
single
nuclei and
basophilic
cytoplasm
Bone marrow iron Usually Increased Markedly Absence of Moderately - -
increased bone marrow increased
iron: “Gold
standard”
test,
 demonstrated
by –ve
Prussian blue
reaction
Hematopoiesis - - - - - Marrow
aplasia(bone
marrow
biopsy)Paucit
y of all
erythroid,
myeloid and
megakaryocyt
ic precursors
Others Exramedullary - - - Bleeding Marrow
hematopoiesis time: aplasia(bone
Prolonged, marrow
Clotting biopsy
time,PT Other cells:
and PTT: Lymphocytes
Normal, and plasma
Tournique cells are
test and prominent
tests for
platelet
autoantibo
dies: +ve