Anemia is a drop in hemoglobin below normal values. Carrying out a biological assessment will make it possible to identify the underlying cause. What analyzes to do?
As a reminder, “Anemia is a drop in hemoglobin below normal values“, specifies Dr. Anaïs Briand, general practitioner. For men, it is below 13 grams per deciliter of blood. And for women below 12 grams per deciliter of blood.
► “The biological assessment will identify the underlying cause of the anemia“. Complete blood count (NFS) is the basic test for diagnosing anemia. It measures the number of red blood cells, white blood cells and platelets in the blood, as well as other blood parameters, such as hemoglobin and hematocrit. “We will be interested in MCV (mean corpuscular volume) which is a reflection of the size of the red blood cells. If it is lower than normal, we will speak ofmicrocytic anemiaif normal, dnormocytic anemia and if it is higher than normal,macrocytic anemia”.
► In the case of a microcytic anemiaseveral causes are considered. “The first is the iron deficiency. We will then ask for a martial assessment including in particular ferritin testa protein that stores iron in the body“A low ferritin level indicates iron deficiency, which is the most common cause of anemia in France.”Iron supplementation may then be offered on medical prescription. Prolonged inflammation can also cause microcytic anemia. “In this case, we will go to measure the CRP, which is a protein increased during inflammation“.
► For a normocytic anemia, there are many causes, often multifactorial and central. “Decreased kidney function is a cause to consider. We will then ask a creatinine test“. Depending on the results, the patient can be referred to a nephrologist.
► In the case of a macrocytic anemia, we are moving towards a deficiency in vitamins B9 and B12. “The dosage of vitamins B9 and B12 will allow to see if there is a deficiency (which will be supplemented). A vitamin B12 deficiency can be a sign of Biermer’s disease (which causes a lack of absorption of this vitamin). Macrocytic anemias can also be due to thyroid disorders. In addition, the doctor can check thyroid function with a TSH test“. Finally, reticulocyte assay can also be requested in addition to the NFS. “These are cells that testify to the production of red blood cells by the bone marrow. A high level is a sign of regenerative anemia, a low level of nonregenerative anemia“. In certain situations, the assessment will be completed according to the opinion of the hematologist.
Thanks to Dr Anaïs Briand, general practitioner.