Abstract

Anemia is defined as an insufficient red blood cell mass to adequately deliver oxygen to peripheral tissues. It is the most common problem in the community. The first steps in the diagnosis of anemia include history, physical exam, complete blood count (CBC), reticulocyte count and examination of the peripheral blood smear. The most common anemia in the community is the iron deficiency anemia which is involved in microcytic anemias. The parameters showing iron status are important for the discrimination of iron deficiency anemia from other microcytic anemias. Chronic iron loss is the most common cause of iron deficiency anemia and therefore, every adult patient with iron deficiency must be evaluated for blood loss. Anemia of chronic disease which is associated with inflammation can be microcytic but more frequently normocytic. A large number of patients admitted to hospital in daily practice have anemia of chronic disease. Another important reason of normocytic anemia is the anemia due to renal failure. Hemolytic anemias which compose a heterogeneous group, are usually normocytic. Although nonmegaloblastic macrocytic anemias form a larger group, megaloblastic macrocytic anemias due to vitamin B12 or folic acid deficiency are more important in the clinical practice. Anemia is a frequent feature of cardiovascular diseases. It must be evaluated carefully in heart failure and coronary artery diseases. Anemia is not a disease, it must be evaluated as a feature of a disease, therefore the reasons of anemia must be investigated.