Anemia – Types and Blood Tests

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Blood deficiency, also known as anemia, is a condition that pertains to irregularities in peripheral blood parameters, specifically a lack of erythrocytes, the red blood cells responsible for the transport of breathing gases, or the concentration of the colorant erythrocyte hemoglobin. The appropriate number of erythrocytes in women should be 3.9-5.6M/µl, and in men - 4.5-6.5 M/µl, while the reference value of hemoglobin concentration in red blood cells should be within the range of approximately 32-36 g/dl.

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Clinical forms and classification of anemia

1. Iron deficiency anemia – The most prevalent form of anemia worldwide, triggered by inadequate dietary intake, impaired intestinal absorption, or chronic occult blood loss. Erythrocytes exhibit characteristic microcytosis (diminished MCV) and hypochromia (diminished MCH) due to defective heme synthesis.

2. Aplastic anemia – A rare, life-threatening bone marrow failure disorder characterized by hematopoietic stem cell destruction and marked pancytopenia, frequently precipitated by viral infections, autoimmune processes, or toxic chemical exposure.

3. Hemolytic anemia – Arises when red blood cell survival drops drastically below the normal 120-day lifespan due to accelerated intra- or extravascular destruction. Hallmark findings include elevated indirect bilirubin, clinical jaundice, increased urinary urobilinogen, and diminished circulating haptoglobin.

4. Post-hemorrhagic anemia – Develops subsequent to acute massive hemorrhage (trauma, surgical complications, gastrointestinal ulcer rupture) or heavy uterine bleeding. It manifests clinically with acute hypotension, compensatory tachycardia, pallor, and orthostatic dizziness.

5. Anemia of pregnancy – Affects up to 40% of expectant mothers as plasma volume expansion (hemodilution) outpaces erythrocytic mass increases. Daily iron requirements surge to approximately 27 mg to sustain fetal development and placental tissue growth.

6. Anemia of chronic disease (ACD) – Associated with systemic inflammation, chronic infections, autoimmune pathologies, and malignancies. Inflammatory cytokines like interleukin-6 drive hepatic hepcidin overproduction, sequestering iron within macrophages and blunting erythropoietin responsiveness.

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Laboratory blood analysis for the diagnostic assessment of anemia

To accurately identify the presence of anemia, a comprehensive evaluation of complete blood count parameters is essential, with particular emphasis on **hematocrit**—the proportion of packed cellular components (including erythrocytes, platelets, and leukocytes) relative to the total volume of peripheral blood. Equally critical are indices such as **MCV** (mean corpuscular volume, reflecting average red blood cell size), **MCH** (mean corpuscular hemoglobin, indicating the average hemoglobin content per erythrocyte), and **MCHC** (mean corpuscular hemoglobin concentration, representing hemoglobin density within red blood cells). Additionally, the assessment must include levels of key nutritional factors, specifically **vitamin B9 (folate)** and **vitamin B12 (cobalamin)**, deficiencies of which are strongly associated with impaired erythropoiesis. Further diagnostic clarity is provided by measuring **ferritin** (a marker of iron storage) and **transferrin** (an iron-transport protein). Complementary evaluations should also encompass **bilirubin** levels in blood—a byproduct of hemoglobin breakdown—as well as **urobilinogen** in urine, both of which may signal accelerated erythrocyte destruction.

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