Evaluation of anemia

Last reviewed: 7 Apr 2025
Last updated: 24 Sep 2024

Summary

Differentials

Common

  • Trauma
  • Acute gastrointestinal bleeding
  • Rupture of a vascular aneurysm
  • Surgery
  • Menorrhagia
  • Iron deficiency
  • Vitamin B12 deficiency
  • Folate deficiency
  • Myelodysplastic syndrome
  • Acute lymphoblastic leukemia
  • Acute myeloid leukemia
  • Chronic myeloid leukemia
  • Hairy cell leukemia
  • Acquired aplastic anemia
  • Infiltration by secondary malignancy
  • Pure red cell aplasia
  • Drug toxicity
  • Anemia of chronic disease
  • Chronic kidney disease
  • Chronic liver disease
  • Pregnancy
Full details

Uncommon

  • Generalized malnutrition
  • Cytotoxic chemotherapy
  • Radiation therapy
  • Alcohol misuse
  • Lead toxicity
  • Hypothyroidism
  • Autoimmune hemolytic anemia
  • Transfusion reaction
  • Malaria
  • Viral hepatitis
  • Toxoplasmosis
  • Leishmaniasis
  • Parvovirus B19 infection
  • Infectious mononucleosis
  • Cytomegalovirus (CMV)
  • Sickle cell anemia
  • Thalassemias
  • Hereditary spherocytosis
  • Glucose-6-phosphate dehydrogenase deficiency (G6PD)
  • Bone marrow failure syndromes
  • Hemolytic uremic syndrome
  • Disseminated intravascular coagulation (DIC)
  • Thrombotic thrombocytopenic purpura
  • Hemangioma
  • Malignant hypertension
  • Prosthetic valves and surfaces
  • Cutaneous burns
Full details

Contributors

Authors

Robert Zaiden, MD

Hematologist Oncologist

Baptist MD Anderson Cancer Center

Jacksonville

FL

Disclosures

RZ declares that he has no competing interests.

Acknowledgements

Dr Robert Zaiden would like to gratefully acknowledge Dr Fauzia Rana, a previous contributor to this topic.

Disclosures

FR declares that she has no competing interests.

Peer reviewers

Christoph Pechlaner, MD

Associate Professor of Medicine

Innsbruck Medical University

Innsbruck

Austria

Disclosures

CP declares that he has no competing interests.

John Densmore, MD, PhD

Associate Professor of Clinical Medicine

Department of Medicine

Division of Hematology/Oncology

University of Virginia

Charlottesville

VA

Disclosures

JD declares that he has no competing interests.

Carlos Aravena, MD

Internal Medicine Instructor

Member of Evidence Based Medicine Unit

Catholic University of Chile

Santiago

Chile

Disclosures

CA declares that he has no competing interests.

References

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Key articles

Snook J, Bhala N, Beales ILP, et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut. 2021 Nov;70(11):2030-51.Full text  Abstract

Ko CW, Siddique SM, Patel A, et al. AGA clinical practice guidelines on the gastrointestinal evaluation of iron deficiency anemia. Gastroenterology. 2020 Sep;159(3):1085-94.Full text  Abstract

Kulasekararaj A, Cavenagh J, Dokal I, et al. Guidelines for the diagnosis and management of adult aplastic anaemia: a British Society for Haematology guideline. Br J Haematol. 2024 Mar;204(3):784-804.Full text  Abstract

Bain BJ, Daniel Y, Henthorn J, et al. Significant haemoglobinopathies: a guideline for screening and diagnosis. Br J Haematol. 2023 Jun;201(6):1047-65.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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