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ANEMIA EXAMINATION PANEL
Thu, 11 Aug 2022
Indonesia is one of the countries with a high incidence of anemia. Anemia or also known as lack of blood is a condition in which red blood cells (hemoglobin) which are responsible for binding oxygen have insufficient amounts or are unable to function properly. As a result, the cells in the body will lack oxygen intake. Unfortunately, some people often do not realize whether they are anemic or not. The symptoms that are felt are often not realized until in the end it is only known that the anemia condition is severe. Early examination needs to be done so that we can find out what our health status is like.
The diagnosis of anemia can be made through several steps, including:
1. History
This can be known from any complaints or symptoms expressed by the patient. Common symptoms of anemia include weakness and frequent headaches, frequent drowsiness, pale or yellow skin, irregular heartbeat, cold hands and feet, and shortness of breath. When we see this complaint in a patient, we should suspect that one of the causes is anemia. Through the anamnesis we can also ask whether the patient has a previous history of anemia, whether there is a history of bleeding, or if there is a family history of anemia or red blood cell abnormalities.
2. Physical Examination
Signs that can be found include pale skin color, anemic conjunctiva, pale oral mucosa, increased respiratory rate, increased heart rate and heart rhythm disturbances, enlarged spleen (spleenomegaly), and pale acral parts.
3. Complete Blood Examination
This is done to determine the number of red blood cells (erythrocytes), hematocrit, hemoglobin, MCV, MCH and MCHC. Normal hemoglobin values in adults are 14-18 g/dL for men and 12-16 g/dL for women. Normal hematocrit values in adults vary between 40-52% for men and 35-47% for women. For MCV, MCH, and MCHC levels are used to help determine the diagnosis based on the cause of anemia. Normal MCV levels are 80-100 fL. Normal MCH levels are 26-34 pg/cell. Normal MCHC levels are 32-36 g/dL. Decreased levels of MCV, MCH, MCHC can be found in Iron Deficiency Anemia or Thalassemia. Meanwhile, if an increase is found, it can be an indication of hemolytic anemia or B12 and folic acid deficiency anemia.
4. Blood smear and differential examination
If the complete blood count shows anemia, then this test is done as a follow-up test to count red blood cells in more detail. The results of these tests can provide additional information for the diagnosis of anemia, such as the shape of the red blood cells and the presence of abnormal cells, which can help diagnose and differentiate the type of anemia.
5. Reticulocyte Examination
Reticulocytes are red blood cells that are still developing or immature. The normal level is about 1% in erythrocytes. Elevated reticulocyte levels are usually found in anemia caused by acute or chronic bleeding or in hemolytic anemia. While a decrease in reticulocytes usually indicates a problem in the production process of these cells, for example in aplastic anemia.
6. Examination of Reticulocyte Hemoglobin (Ret-He)
Used to see any changes in hemoglobin levels and the number of reticulocytes, which is very useful to see the success of therapy in anemic patients.
7. Other anemia investigations
It aims to determine the cause of the anemia that occurs. For example, in Aplastic Anemia, it is necessary to do a bone marrow examination to strengthen the diagnosis. Or in Iron Deficiency Anemia, it is necessary to do an iron profile examination to determine how severe the level of deficiency is.
If the supporting examination has been carried out and the diagnosis has been established, then treatment can be carried out according to their respective causes so that the anemia condition can be resolved.
Author: dr. A.A.Ayu Trisna P.W.S (Medical Consultant Doctor PRAMITA Clinical Laboratory Jl. Cik Ditiro No. 17, Yogyakarta)
The diagnosis of anemia can be made through several steps, including:
1. History
This can be known from any complaints or symptoms expressed by the patient. Common symptoms of anemia include weakness and frequent headaches, frequent drowsiness, pale or yellow skin, irregular heartbeat, cold hands and feet, and shortness of breath. When we see this complaint in a patient, we should suspect that one of the causes is anemia. Through the anamnesis we can also ask whether the patient has a previous history of anemia, whether there is a history of bleeding, or if there is a family history of anemia or red blood cell abnormalities.
2. Physical Examination
Signs that can be found include pale skin color, anemic conjunctiva, pale oral mucosa, increased respiratory rate, increased heart rate and heart rhythm disturbances, enlarged spleen (spleenomegaly), and pale acral parts.
3. Complete Blood Examination
This is done to determine the number of red blood cells (erythrocytes), hematocrit, hemoglobin, MCV, MCH and MCHC. Normal hemoglobin values in adults are 14-18 g/dL for men and 12-16 g/dL for women. Normal hematocrit values in adults vary between 40-52% for men and 35-47% for women. For MCV, MCH, and MCHC levels are used to help determine the diagnosis based on the cause of anemia. Normal MCV levels are 80-100 fL. Normal MCH levels are 26-34 pg/cell. Normal MCHC levels are 32-36 g/dL. Decreased levels of MCV, MCH, MCHC can be found in Iron Deficiency Anemia or Thalassemia. Meanwhile, if an increase is found, it can be an indication of hemolytic anemia or B12 and folic acid deficiency anemia.
4. Blood smear and differential examination
If the complete blood count shows anemia, then this test is done as a follow-up test to count red blood cells in more detail. The results of these tests can provide additional information for the diagnosis of anemia, such as the shape of the red blood cells and the presence of abnormal cells, which can help diagnose and differentiate the type of anemia.
5. Reticulocyte Examination
Reticulocytes are red blood cells that are still developing or immature. The normal level is about 1% in erythrocytes. Elevated reticulocyte levels are usually found in anemia caused by acute or chronic bleeding or in hemolytic anemia. While a decrease in reticulocytes usually indicates a problem in the production process of these cells, for example in aplastic anemia.
6. Examination of Reticulocyte Hemoglobin (Ret-He)
Used to see any changes in hemoglobin levels and the number of reticulocytes, which is very useful to see the success of therapy in anemic patients.
7. Other anemia investigations
It aims to determine the cause of the anemia that occurs. For example, in Aplastic Anemia, it is necessary to do a bone marrow examination to strengthen the diagnosis. Or in Iron Deficiency Anemia, it is necessary to do an iron profile examination to determine how severe the level of deficiency is.
If the supporting examination has been carried out and the diagnosis has been established, then treatment can be carried out according to their respective causes so that the anemia condition can be resolved.
Author: dr. A.A.Ayu Trisna P.W.S (Medical Consultant Doctor PRAMITA Clinical Laboratory Jl. Cik Ditiro No. 17, Yogyakarta)
