The morphological classification of anemia in humans, as first proposed by Max Wintrobe, considers the MCV as the first branch point, and the MCHC as the second branch point in microcytic anemias alone. In contrast, the classification of anemia in cats considers all permeations of MCV and MCHC. I think we can learn from our veterinary colleagues! An expanded classification for humans might look something like this:
- Microcytic hypochromic
- Iron deficiency anemia
- Anemia of inflammation
- Microcytic normochromic – thalassemia minor
- Microcytic hyperchromic
- Hereditary spherocytosis
- Autoimmune hemolytic anemia
- Hb C
- Normocytic hypochromic – ID, AI
- Iron deficiency anemia
- Anemia of inflammation
- Normocytic normochromic – Large ddx
- Normocytic hyperchromic
- Hereditary spherocytosis
- Autoimmune hemolytic anemia
- Macrocytic hypochromic – Reticulocytosis
- Macrocytic normochromic – Large ddx
- Macrocytic hyperchromic – Cold agglutinin disease (artifact)