Notes · Hematology & oncology · 7 min read
Anaemia: an MCV-based approach
Classify by red cell size, then confirm with targeted tests.
Key points
- Microcytic causes: iron deficiency, thalassaemia trait, anaemia of chronic disease, sideroblastic anaemia.
- Ferritin below the lower limit confirms iron deficiency; ferritin rises in inflammation.
- Macrocytic, megaloblastic: vitamin B12 or folate deficiency.
- Macrocytic, non-megaloblastic: alcohol, liver disease, hypothyroidism, reticulocytosis, myelodysplasia.
- Normocytic with a high reticulocyte count: haemolysis or acute blood loss.
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