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Chronic Anemia Differential Diagnoses

  • Author: Christopher D Braden, DO; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
 
Updated: Feb 01, 2016
 
 

Diagnostic Considerations

Be vigilant for acute blood loss while attributing low Hgb and hematocrit values to a chronic state.

Consider anemia as an etiologic factor in patients who present with dyspnea, headache, angina, or altered mental status.

Consider anemia as a contributing factor to jaundice (hemolytic anemia) while focusing on other conditions, such as acute hepatitis, that can present with jaundice.

Be vigilant for the presence of pancytopenia.

Conditions to consider in the differential diagnosis of anemia, along with those in the next section, include the following:

  • Hemophilia, type A
  • Hemophilia, type B
  • Hemorrhoids
  • Henoch-Sch ö nlein purpura
  • Inflammatory bowel disease
  • Malaria
  • Methemoglobinemia
  • Mononucleosis
  • Mycoplasma pneumonia
  • Cushing syndrome
  • Alcohol and substance abuse
  • Coccidioidomycosis
  • Dengue fever
  • Disseminated intravascular coagulation
  • Dysfunctional uterine bleeding
  • Dysmenorrhea
  • Sarcoidosis
  • Systemic lupus erythematosus

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Christopher D Braden, DO Hematologist/Oncologist, Chancellor Center for Oncology at Deaconess Hospital

Disclosure: Nothing to disclose.

Coauthor(s)

Eric Wilke, MD Medical Director, Traditions Emergency Medicine, College Station Medical Center

Eric Wilke, MD is a member of the following medical societies: American College of Emergency Physicians, Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jeffrey L Arnold, MD, FACEP Chairman, Department of Emergency Medicine, Santa Clara Valley Medical Center

Jeffrey L Arnold, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director for Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, Society for Academic Emergency Medicine, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Roy Alson, MD, PhD, FACEP, FAAEM Associate Professor, Department of Emergency Medicine, Wake Forest University School of Medicine; Medical Director, Forsyth County EMS; Deputy Medical Advisor, North Carolina Office of EMS; Associate Medical Director, North Carolina Baptist AirCare

Roy Alson, MD, PhD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, World Association for Disaster and Emergency Medicine, National Association of EMS Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Fredrick Melik Abrahamian, DO, FACEP,to the development and writing of the source article.

References
  1. McLennan JD, Steele M. Extent of microcytic anemia among children in a low-income, peri-urban community in the Dominican Republic using different cut-points. J Trop Pediatr. 2015 Apr. 61 (2):86-91. [Medline].

  2. [Guideline] American College of Obstetricians and Gynecologists (ACOG). Anemia in pregnancy. 2008 Jul. [Full Text].

  3. Zittermann A, Jungvogel A, Prokop S, Kuhn J, Dreier J, Fuchs U, et al. Vitamin D deficiency is an independent predictor of anemia in end-stage heart failure. Clin Res Cardiol. 2011 Apr 7. [Medline].

  4. Omar N, Salama K, Adolf S, El-Saeed GS, Abdel Ghaffar N, Ezzat N. Major risk of blood transfusion in hemolytic anemia patients. Blood Coagul Fibrinolysis. 2011 Apr 19. [Medline].

  5. Gao C, Li L, Chen B, Song H, Cheng J, Zhang X, et al. Clinical outcomes of transfusion-associated iron overload in patients with refractory chronic anemia. Patient Prefer Adherence. 2014. 8:513-7. [Medline].

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