Morphologic Classification of Anemias

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Morphologic Classification of Anemias

Red blood cell morphology is another system for classifying anemia. There are three basic divisions within the morphologic classification system:
  1. Microcytic -- MCV <80 fL
  2. Macrocytic -- MCV >100 fL
  3. Normocytic -- MCV 80-100 fL
The table below provides examples of anemias in each category.
Table 3: Anemia Classifications based on MCV
CategoryAnemia
Microcytic (MCV <80 fL)
  • Iron Deficiency
  • Anemia of Chronic Inflammation
  • Sideroblastic Anemia
  • Globin deficiency - Thalassemia
Macrocytic (MCV >100 fL) Megaloblastic
  • Vit B12 deficiency
    • Nutritional deficiency
    • Malabsorption
    • Pernicious Anemia (autoimmune)
  • Folate deficiency
Non-megaloblastic
  • Chronic Liver Disease
  • Alcoholism
  • Aplastic Anemia (hypoproliferative)
Normocytic (MCV 80 - 100 fL) Hemolytic Anemias
  • Spherocytosis, elliptocytosis
  • Acanthocytosis, stomatocytosis
  • Immune hemolysis
  • Mechanical - cardiac valve prosthesis
  • Burns
Bone marrow suppression
  • Antibody-mediated
  • Infection - malaria
  • Chemical and physical agents - drugs, toxins
Adopted from Rodak, 2020.