Anaemia: Beyond Iron Deficiency—Why a Thorough Diagnosis Matters

Blood bag prepared for transfusion.

Anaemia affects over 1.6 billion people globally, yet many assume iron deficiency is the sole cause. Anaemia encompasses a spectrum of conditions, each requiring distinct evaluation and treatment.

Types of Anaemia

• Vitamin Deficiency Anaemia: This is caused by insufficient vitamin B12 or folate, leading to megaloblastic anaemia, which is characterised by large, immature red blood cells.

• Anaemia of Chronic Disease: This type is linked to chronic infections, autoimmune diseases, or cancer anaemia, characterised by impaired iron utilisation despite adequate iron stores.

• Haemolytic Anaemia: Results from the premature destruction of red blood cells due to autoimmune disorders, genetic conditions, or infections. 

• Aplastic Anaemia: A rare condition where the bone marrow fails to produce sufficient blood cells, often due to autoimmune causes or exposure to toxins.

Importance of Comprehensive Evaluation

Relying solely on iron supplementation without proper diagnosis can mask underlying issues and delay appropriate treatment. A thorough workup—including complete blood count (CBC), reticulocyte count, iron studies, vitamin B12 and folate levels, and, when necessary, bone marrow biopsy—is essential to identify the specific type and cause of anaemia. 

Conclusion

An accurate diagnosis is crucial for effective anaemia management. Healthcare providers should consider the full clinical picture and utilise appropriate diagnostic tools to ensure targeted and effective treatment strategies.

Keywords: Anaemia, Vitamin B12 deficiency, Folate deficiency, Anaemia of chronic disease, Hemolytic anaemia, Aplastic anaemia, Diagnostic workup, Iron supplementation.