II. History

  1. See Iron Deficiency Anemia for related history
  2. Family History of Anemia
    1. Hereditary Spherocytosis
    2. Sickle Cell Anemia (Black patients)
    3. Thalassemia (Asian, Black, or Mediterranean patients)
    4. Other Hemoglobinopathy
    5. Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD)
      1. Black, Greek, Filipino, Jewish, Sardinian patients
      2. X-linked inheritance (consider in males)
  3. History of chronic illness (Anemia of Chronic Disease)
    1. Chronic infection
    2. Collagen vascular disease
    3. Malignancy
    4. Hypothyroidism
    5. Hypoadrenalism
    6. Renal disease
    7. Hypopituitarism
  4. Dietary habits
    1. Inadequate Iron or Protein intake: Iron Deficiency
    2. Strict Vegetarian: Vitamin B12 Deficiency
    3. Diet lacking fruits and vegetables: Folate Deficiency
  5. History of Gastrectomy or Malabsorption (e.g. Diarrhea)
    1. Vitamin B12 Deficiency
    2. Iron Deficiency Anemia
    3. Folate DeficiencyAnemia
  6. Recent Infection
    1. Parvovirus: Erythroblastopenia
    2. Hepatitis: Aplastic Anemia
  7. Medications
    1. See Medication Causes of Macrocytic Anemia
    2. Oxidant medications provoke G6PD
  8. Abdominal Pain
    1. Peptic Ulcer Disease
    2. Lead Toxicity
    3. Porphyria
  9. Pica
    1. Suggests Iron Deficiency Anemia

III. Symptoms

  1. Many patients are asymptomatic
    1. Mild Anemia (Hemoglobin over 10 g/dl)
    2. Gradual onset of Anemia
    3. Active, well-conditioned persons
  2. Non-specific Symptoms
    1. Fatigue
    2. Generalized weakness
    3. Dyspnea on exertion
    4. Light headed
    5. Pruritus (Iron Deficiency Anemia)

IV. Signs: Anemia

  1. Thorough, systematic exam for Anemia cause
    1. Abdominal and pelvic exam
    2. Rectal exam with Stool Guaiac for occult blood
  2. Pallor in severe Anemia (Hct <25%, Hgb <7 g/dl)
    1. Pale Conjunctiva or mucous membranes
    2. Pallor at the nail beds or palmar creases

VI. References

  1. Oblender in Daeschner (1991) Pediatrics, p. 281
  2. Irwin (2001) Am Fam Physician 64(8):1379-86 [PubMed]

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Related Studies

Ontology: O/E - anemia (C0475143)

Concepts Finding (T033)
SnomedCT 164139008, 164144001, 141336002, 141341005
Spanish al examen: anemia (hallazgo), al examen: anemia (categoría dependiente del contexto), al examen: anemia, SAI (categoría dependiente del contexto), O/E - anaemia NOS, al examen: anemia, SAI (hallazgo), O/E - anemia NOS, al examen: anemia, SAI, al examen: anemia, SAI (trastorno), al examen: anemia
English O/E - anaemia NOS, O/E - anemia NOS, On examination - anemia, On examination - anemia NOS (disorder), O/E - anaemia (finding), O/E - anaemia NOS (finding), On examination - anemia NOS, O/E - anaemia, O/E - anaemic, O/E - anemia, O/E - anemic, On examination - anemia (context-dependent category), On examination - anemia NOS (context-dependent category), On examination - anemia (finding)

Ontology: H/O: anemia (C0559154)

Concepts Finding (T033)
SnomedCT 275538002, 161459002, 138726004, 138730001, 161455008
English H/O: anaemia NOS, H/O: anemia NOS, History of - anemia (context-dependent category), History of - anemia NOS (context-dependent category), History of - anemia NOS, History of - anemia NOS (situation), H/O: anaemia NOS (situation), History of - anaemia NOS, History of anemia (situation), History of - anemia, History of anemia, History of - anemia (situation), H/O: anaemia, H/O: anemia
Spanish antecedente de: anemia (situación), antecedente de: anemia (categoría dependiente del contexto), antecedente de anemia, SAI (categoría dependiente del contexto), historia de anemia, SAI, antecedente de anemia, SAI, antecedente de anemia, SAI (situación), H/O: anemia NOS, H/O: anaemia NOS, antecedente de: anemia