Anemia as a Problem: GP Approach

Dig Dis. 2022;40(3):370-375. doi: 10.1159/000517579. Epub 2021 Jun 9.

Abstract

Background: Anemia is a presentation of an underlying disease or deficiency. As stated by the WHO, anemia is defined as hemoglobin (Hb) levels <12.0 g/dL in women and <13.0 g/dL in men. This review of clinical practice aimed to determine the diagnostic approach to anemia in primary care patients.

Summary: Nutritional deficiencies, medications, chronic inflammatory conditions, malignancy, renal dysfunction, and bone marrow and inherent disorders contribute to anemia development. Anemia is classified and diagnosed by the values of hematological parameters, underlying pathological mechanism, and patient history. The diagnostic approach of anemia in primary care settings is focused on history, physical examination, laboratory findings including complete blood cell count, reticulocyte count, and peripheral smear examination, fecal occult blood test, and ultrasound findings.

Key messages: Anemia is the most common hematological disorder that represents a major health burden worldwide. Hb levels alter with gender, ethnicity, and physiological status. Anemia is often multifactorial. The evaluation of a patient with anemia in primary care includes clinical history, physical examination, and laboratory findings with fecal occult blood test and abdominal ultrasound. The wide variations in general practice in European countries are based on different health care systems but also knowledge of GPs that reflect educational and research policy.

Keywords: Anemia; Diagnostic algorithm; Primary care.

Publication types

  • Review

MeSH terms

  • Anemia* / diagnosis
  • Anemia* / drug therapy
  • Chronic Disease
  • Europe
  • Female
  • Hemoglobins / analysis
  • Humans
  • Male

Substances

  • Hemoglobins