Laboratories

1. de Guzman Raquel Isabelle & de Leon Gemma Rosa Laboratories

2. Laboratory Findings Patient’s peripheral smear: severe hypochromic RBCs with remarkable anisocytosis, no abnormal WBCs but there are some hypersegmentedneutrophils; the platelet count is increased

3. Laboratories

4. Laboratories

5. What Happens When There is Gradual Depletion of Iron Stores?

6. Other Laboratory tests to establish IDA etiology • Testing stool for the presence of hemoglobin • to establish GI bleed as etiologyof IDA • chemical testing that detects more than 20 mL of blood loss daily from the upper gastrointestinal tract is employed • benzidinemethod, or red blood cells can be radiolabeled with radiochromium and retransfused

7. Test for Hemoglobinuria • Is suspected if a freshly obtained urine specimen appears bloody but contains no red blood cells • Confirmed by precipitation ofhemoglobin but not myoglobin using 60% ammonium sulfate

8. With less severe hemolytic disorders, there may be no significant hemoglobinuria. • Investigate renal loss of iron by staining the urine sediment for iron. Hemosiderin is detected intracellularly.

9. “When the diagnosis remains ambiguous after laboratory results are analyzed, a bone marrow biopsy should be considered in order to make a definitive diagnosis. The absence of stainable iron is the ‘gold standard’ for diagnosis of IDA.” Zhu, A. et al. Evaluation and Treatment of Iron Deficiency Anemia: A Gastroenterological Perspective Dig Dis Sci. 2010 January; 55(3): 548–559.

10. Bone Marrow Aspirate • Largely replaced by measurement of serum iron, TIBC, and serum ferritin in diagnosing iron deficiency anemia • The absence of stainable iron in a bone marrow aspirate that contains spicules and a simultaneous control specimen containing stainable iron permit establishment of a diagnosis of iron deficiency without other laboratory tests. • Also diagnostic in identifying the sideroblasticanemias by showing ringed sideroblasts in the aspirate stained with Perls stain.