Laboratory tests for anemia
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Key Laboratory Tests for Anemia Diagnosis
Laboratory testing is essential for diagnosing anemia, determining its type, and guiding treatment. The most common and important laboratory tests include the Complete Blood Count (CBC), serum ferritin, serum iron, and specialized tests for specific anemia types 1234.
Complete Blood Count (CBC) and Red Blood Cell Indices
The CBC is the primary test for detecting anemia. It measures hemoglobin concentration, hematocrit, red blood cell (RBC) count, and red cell indices such as mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW). These parameters help identify the presence, severity, and type of anemia (microcytic, normocytic, or macrocytic) 124. In anemia, most RBC indicators are lower than in healthy individuals, except for RDW, which may be increased in certain types .
Serum Ferritin and Iron Studies
Serum ferritin is a key test for assessing iron stores in the body and is highly effective for diagnosing iron deficiency anemia. It is considered the most powerful single laboratory test for this purpose, with high sensitivity and specificity 13. Additional iron studies, such as serum iron, total iron-binding capacity (TIBC), and transferrin saturation, further help differentiate iron deficiency anemia from other causes 23.
Specialized Tests for Anemia Subtypes
For specific types of anemia, additional laboratory tests are used:
- Hemolytic Anemia: Reticulocyte count, peripheral blood smear, and tests for hemolysis (such as lactate dehydrogenase, haptoglobin, and bilirubin) are important. If the cause is unclear, genetic testing may be recommended .
- Aplastic Anemia and Bone Marrow Disorders: Bone marrow examination and tests for folic acid and vitamin B12 levels may be necessary 29.
- Chronic Disease and Renal Anemia: Extensive laboratory analysis can help identify anemia of chronic disease, renal anemia, and cases with multiple contributing factors .
Point-of-Care and Emerging Diagnostic Technologies
Recent advances have led to the development of portable and point-of-care (POC) devices for anemia diagnosis. Smartphone-based hemoglobin analyzers and color-based POC tests like AnemoCheck-LRS offer rapid, affordable, and accurate hemoglobin measurement, especially useful in resource-limited settings and for home monitoring 7810. These technologies have shown high sensitivity and specificity, making them valuable for screening and managing anemia in high-risk populations 710.
Laboratory Workflow and Quality Assurance
Accurate anemia diagnosis depends not only on the choice of tests but also on proper sample handling, quality assurance protocols, and multidisciplinary collaboration among laboratory professionals. Attention to pre-analytical, analytical, and post-analytical factors ensures reliable results and optimal patient care 15.
Conclusion
Laboratory tests are central to the detection, classification, and management of anemia. The CBC and serum ferritin are foundational, while additional tests help clarify the underlying cause. New point-of-care technologies are expanding access to accurate anemia diagnostics, particularly in underserved areas. A comprehensive, quality-driven laboratory approach is essential for precise diagnosis and effective treatment of anemia 12345678+2 MORE.
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