{"id":1295,"date":"2017-06-23T19:18:34","date_gmt":"2017-06-23T19:18:34","guid":{"rendered":"http:\/\/papergp.com\/index.php\/data-interpretation\/fbc\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"fbc","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/data-interpretation\/fbc-2\/fbc\/","title":{"rendered":"Anaemia"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Low MCV<\/h4>\n<ul>\n<li>Check ferritin\n<ul>\n<li>(beware falsely normal ferritin as also inflammatory marker)<\/li>\n<li>If low &#8211; confirmed iron deficiency anaemia\n<ul>\n<li>Consider 2ww lower GI\n<ul>\n<li>Unexplained anaemia in men or non-menstruating women<\/li>\n<li>FH &#8211; colorectal cancer in first degree relatives<\/li>\n<\/ul>\n<\/li>\n<li>History: Heavy periods, diet, urine dip, stool parasites<\/li>\n<li>Investigate: Coeliacs serology (TTG)<\/li>\n<li>Treat: Ferrous fumarate OD and increase as tolerated to BD + consider laxative &#8211; recheck Hb\/Ferritin in 3 months<\/li>\n<\/ul>\n<\/li>\n<li>If normal\/raised &#8211; consider anaemia of chronic disease or ferritin acting as acute phase reactant (in which case check serum iron\/TIBC)\n<ul>\n<li>raised serum iron\/TIBC and reduced transferrin saturation indicates iron deficiency<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>consider Hb electrophoresis\n<ul>\n<li>Beta Thalassaemia trait &#8211; raised HbA2<\/li>\n<li>Alpha Thalassaemia trait &#8211; difficult diagnosis as no specific test\n<ul>\n<li>If confirmed, discuss with haematology as appropriate<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Normal MCV<\/h4>\n<ul>\n<li>Consider\n<ul>\n<li>anaemia of chronic disease &#8211; chronic inflammation, endocrine, CKD, liver disease, malnutrition, MDS, haemochromatosis<\/li>\n<li>mixed haematinic deficiency<\/li>\n<li>recent blood loss<\/li>\n<li>investigate as per raised MCV<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Raised MCV<\/h4>\n<ul>\n<li>History: bleeding, diet, medications, alcohol, FHx, recent transfusion<\/li>\n<li>Investigate: U+Es, LFTs+GGT, TFTs, B12, Folate, Blood film, Reticulocytes<\/li>\n<li>Consider myeloma screen: serum\/urine electrophoresis, immunoglobulins, bone profile<\/li>\n<li>Refer to haematology if\n<ul>\n<li>abnormal cell shapes on blood film<\/li>\n<li>persistent unexplained anaemia, raised MCV or B12 deficiency<\/li>\n<li>spherocytes on blood film -&gt; DAT + reticulocytes -&gt; refer if raised<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Notes:<\/h4>\n<ul>\n<li>Abnormalities affecting more than one cell type (Hb, WCC, platelets) are more likely due to bone marrow causes. Consider early referral if the patient is unwell<\/li>\n<li>Urgent referral to haematology\n<ul>\n<li>Leucoerythroblastic anaemia on blood film<\/li>\n<li>Unexplained progressive symptomatic anaemia<\/li>\n<li>Associated splenomegaly\/lymphadenopathy or other cytopenias<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Low MCV Check ferritin (beware falsely normal ferritin as also inflammatory marker) If low &#8211; confirmed iron deficiency anaemia Consider 2ww lower GI Unexplained anaemia in men or non-menstruating women FH &#8211; colorectal cancer in first degree relatives History: Heavy periods, diet, urine dip, stool parasites Investigate: Coeliacs serology (TTG) Treat: Ferrous fumarate OD and &hellip; <a href=\"https:\/\/papergp.com\/index.php\/data-interpretation\/fbc-2\/fbc\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Anaemia<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1301,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1295","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1295","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1295"}],"version-history":[{"count":6,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1295\/revisions"}],"predecessor-version":[{"id":1862,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1295\/revisions\/1862"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1301"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1295"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}