Anemia Types Overview

Hypochromic Microcytic Anemia

• Key features: Mean corpuscular hemoglobin (MCH) below 32 g/dL, Mean corpuscular volume (MCV) below 80 fL.

Iron Deficiency Anemia

• Most common type of hypochromic microcytic anemia.
• Symptoms include fatigue, pallor, brittle nails, and pica (craving non-food items).
• Low serum iron, ferritin, and transferrin saturation.
• Bone marrow iron stores are reduced.
• Laboratory tests will show decreased serum iron, ferritin, and transferrin saturation, and elevated serum transferrin receptor.

Anemia of Chronic Disease

• Reduced serum iron, transferrin, and transferrin with normal or elevated ferritin.
• Reduced iron stores in bone marrow.
• Often associated with chronic infections, inflammatory conditions, and autoimmune diseases.

Sideroblastic Anemia

• Increased serum iron, ferritin (iron storage overload), and transferrin saturation.
• Low transferrin
• Associated with genetic mutations or acquired conditions like alcoholism, B6 deficiency and various other medications.

Thalassemia, Abnormal Hemoglobin

• Abnormal hemoglobin studies (HbF/HbA2).
• Normal or elevated serum iron and ferritin.
• Low transferrin.
• Reduced MCV associated with abnormal haemoglobin

Hemolytic Anemia (Normochromic Normocytic Anemia)

• Intrinsic: Hereditary spherocytosis, paroxysmal nocturnal hemoglobinuria (PNH), G6PD deficiency, pyruvate kinase deficiency, sickle cell anemia, and HbC disease.
• Extrinsic: Microangiopathic hemolytic anemia (MAHA), macroangiopathic hemolytic anemia (Macro-AH), autoimmune hemolytic anemia (AIHA) , and other infectious agents and chemicals.

Non-Hemolytic Anemia (Normochromic Normocytic Anemia)

• Causes include iron deficiency, anemia of chronic disease, chronic kidney disease, and Aplastic anemia

Megaloblastic Anemia

• MCV greater than 100 fL.
• Impaired DNA synthesis resulting from vitamin B12 or folate deficiency
• Symptoms include fatigue, headache, palpitations, dyspnea, neurological symptoms (e.g., paresthesias), and macrocytic red blood cells with oval morphology.
• Laboratory findings include high LDH and indirect bilirubin, low haptoglobin, high or normal reticulocytes, hypersegmented neutrophils.

Blast Cells

• Erythroid maturation: Proerythroblast, basophilic erythroblast, polychromatophilic erythroblast, orthochromatic erythroblast, reticulocyte, erythrocyte
• Granulocytic maturation: myeloblast, promyelocyte, myelocyte, metamyelocyte, band neutrophil, neutrophil
• Lymphoid maturation

Myeloid Leukemia (Acute and Chronic)

• Acute Myeloid Leukemia (AML): Rapid onset; presence of immature myeloid blast cells; can present as different subtypes (M0-M7) based on microscopic features.
• Chronic Myeloid Leukemia (CML): Gradual onset, Mature myeloid cells at differential stages are increased, Philadelphia chromosome translocation (t(9;22)).

Lymphoid Leukemia (Acute and Chronic)

• Acute Lymphocytic Leukemia (ALL): Primarily affects children; characterized by lymphoblast cells; further classified as B-ALL or T-ALL based on specific markers.
• Chronic Lymphocytic Leukemia (CLL): Predominantly affects adults; characterized by mature lymphocytes, with 'smudge cells' (fragile B cells).