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Tareq Abadl: Laboratory Diagnosis of Anemia
Dec 13, 2025, 08:27

Tareq Abadl: Laboratory Diagnosis of Anemia

Tareq Abadl, Medical Laboratory Specialist and Director of the Blood Bank at Dr. Abdelkader Al-Mutawakkil Hospital, posted on LinkedIn:

“Laboratory Diagnosis of Anemia

1. Iron Deficiency Anemia (IDA)

When iron deficiency is suspected, several tests must be evaluated together to get the full picture:

  • Hemoglobin (Hb)

The iron-containing protein that carries oxygen.
Low Hb → early indicator of anemia.

  • Hematocrit (Hct)

Measures the percentage of RBCs in blood.
Low Hct → possible iron deficiency.

  • Ferritin

The main iron-storage protein.
Low ferritin → strongest marker of IDA.

  • Serum Iron

Measures circulating iron in blood.
Low value supports the diagnosis but not enough alone.

  • Total Iron-Binding Capacity (TIBC)

In IDA, TIBC increases because the body tries to capture more iron.

  • Transferrin Saturation

Low saturation → low available iron.

  • RBC Indices

MCV: Low (microcytic)

MCHC: Low (hypochromic)

All these tests together give a complete assessment of iron status and confirm Iron Deficiency Anemia.

2. Hemolytic Anemia (HA)

Hemolytic anemia is a completely different mechanism—RBCs are being destroyed. Key tests include:

  • Hemoglobin (Hb)

Normal or low depending on severity.

  • Reticulocyte Count

Elevated retics → bone marrow trying to compensate for RBC destruction.

  • Peripheral Blood Smear

Fragmented or abnormal RBCs → evidence of hemolysis.

  • Bilirubin (Indirect)

Increases due to breakdown of hemoglobin.

  • Haptoglobin

Decreased because it binds free hemoglobin released during hemolysis.

  • LDH (Lactate Dehydrogenase)

High levels indicate cell destruction.

  • Direct Coombs Test

Positive result → immune-mediated hemolysis.

These tests clarify the type, cause, and severity of hemolysis before treatment decisions.

Summary

  • Iron Deficiency Anemia → Iron profile + RBC indices
  • Hemolytic Anemia → Hemolysis markers + Coombs test + Reticulocytes

Combining the right tests provides accurate diagnosis and guides precise treatment.”

Tareq Abadl

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