Anaemia DDx

Anaemia – Differential Diagnosis

Common causes

• Microcytic anaemia
  • Iron deficiency
  • Thalassaemia
  • Sickle Cell Anaemia
  • Childhood Anaemia
  • Sideroblastic Anaemia
• Normocytic anaemia
  • Anaemia of Chronic Disease
    • Anaemia in CKD
  • Haemolytic Anaemia
  • Myelodysplastic Syndromes
• Macrocytic anaemia
  • B12 & Folate deficiency
  • Alcoholism
  • Hypothyroidism

Must Not Miss

• Acute GI bleeding
• Crohn’s dis/ Ulcerative colitis
• Malignancy
  • GI
  • Multiple myeloma
  • Lymphoma
  • Leukaemia

Easily missed

• Medications
• Coeliac disease
• Myelodysplasia

Red flags

• Iron deficiency anaemia in men
• Iron deficiency in post-menopausal women
• Weight loss
• Bone pain, fever and sweats
• New onset persistent Dyspepsia > 50 years old
• Dysphagia
• Haematemesis /Melaena
• Persistent altered bowel habit: age > 50 years
• Rectal bleeding
• Abnormal examination findings

Investigations to consider

• FBC /blood film, CRP/ESR
• U&Es, LFTs, TFTs
• B12/Folate/Ferritin
• Serum iron and TIBC
• Haemoglobinopathy screen
• Haemolysis screen
• Myeloma screen
• Coeliac screen
• Faecal occult blood
• Urinalysis
• OGD
• Barium enema/Colonoscopy
• Bone scan
• Bone marrow analysis

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