Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ NOTE + ++ *The views expressed in this presentation are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States government. ++ †I am a military service member. This work was prepared as part of my official duties. Title 17, USC, §105 provides that “Copyright protection under this title is not available for any work of the U.S. Government.” Title 17, USC, §101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person’s official duties +++ ANEMIA +++ RED BLOOD CELL (RBC) INDICES ++ Hematocrit (HCT): Volume percentage of RBCs in blood. See Table 12-1 for age-related normal levels Mean corpuscular volume (MCV): Average RBC volume Mean corpuscular hemoglobin (MCH): Average quantity of hemoglobin per RBC Mean corpuscular hemoglobin concentration (MCHC): Grams of hemoglobin per 100 mL of packed RBCs (amount of hemoglobin per unit volume) Red cell distribution width (RDW): Index of the variation in RBC size Reticulocyte count: Percentage of young RBCs in the plasma ++Table Graphic Jump LocationTABLE 12-1 Normal Hemoglobin, Hematocrit, and Mean Corpuscular Volume Values by Age* View Table||Download (.pdf) TABLE 12-1 Normal Hemoglobin, Hematocrit, and Mean Corpuscular Volume Values by Age* Age Hemoglobin (g/dL)* Hematocrit (%)* MCV (Mean −2SD) Newborn 16.8 (13.7–20.1) 55 (45–65) 108 (98) 2 weeks 16.5 (13.0–20.0) 50 (42–66) 105 (86) 3 months 12.0 (9.5–14.5) 36 (31–41) 91 (74) 6 months–2 years 12.0 (10.5–14.0) 37 (33–42) 78 (70) 7–12 years 13.0 (11.0–16.0) 38 (34–40) 86 (77) Women (adult) 14.0 (12.0–16.0) 42 (37–47) 90 (80) Men (adult) 16.0 (14.0–18.0) 47 (42–52) 90 (80) *Mean values with ranges in parentheses. MCV, mean corpuscular volume. These data have been compiled from several sources. +++ DIFFERENTIAL DIAGNOSIS BASED ON MEAN CORPUSCULAR VOLUME ++ Microcytic Anemia ++ Iron deficiency, thalassemia, anemia of inflammation, lead poisoning, sideroblastic anemia, copper deficiency Iron deficiency versus thalassemia trait: RBC count and RDW are often normal in thalassemia trait; in iron deficiency, low RBC count and elevated RDW; Mentzer index (MCV/RBC) serves as useful screen (<13 suggests thalassemia trait, >13 suggests iron deficiency) ++ Normocytic Anemia ++ In normocytic anemia, assess the reticulocyte count. The reticulocyte index accurately reflects erythropoiesis by adjusting for the degree of anemia Reticulocyte index (RI) = % Reticulocyte × Patient HCT/Normal HCT RI is greater than 3% in compensated bleeding or hemolysis and less than 2% in anemia due to decreased RBC production; 1% is normal marrow activity without anemia Reticulocytes low: Pure RBC dysplasia (Diamond–Blackfan anemia), transient erythroblastopenia of childhood, aplastic crisis (e.g., secondary to parvovirus B19 infection), renal disease; acute bleed (without compensation), marrow infiltration (e.g., leukemia, solid ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.