The medical history represents an important component in the diagnosis of anemia. Family history
- Are there individuals in your family with blood disorders? (Southern Europeans, for example, thalassemia or hemoglobinopathy).
- Are there any hereditary diseases in your family?
Social history
- What is your profession?
- Are you exposed to harmful working substances in your profession?
Current medical history/systemic medical history (somatic and psychological complaints).
- Do you feel fatigued and tired?
- Have you noticed a decrease in performance?
- Do you experience shortness of breath on exertion?
- Have you noticed any changes in skin color such as pallor or yellowish skin?
- Have you noticed skin symptoms such as rhagades at the corners of the mouth, aphthae on the oral mucosa, or pale skin/mucous membranes)?
- Do you have hair loss or brittle nails?
- Have you noticed an increased tendency to bleed, such as increased bruising, gum bleeding or nosebleeds?
- Do you suffer from dizziness?
- Do you suffer from ringing in the ears?
- Have you noticed a red coloration of the urine?
- Have you noticed any symptoms such as night sweats or fever?
- Do you suffer from sensory disturbances?
- Have you noticed gait unsteadiness?
- Have you felt ill in the last few weeks?
- Did you suffer or suffer more from infections?
- How long have these symptoms existed?
Vegetative anamnesis including nutritional anamnesis.
- Has your appetite changed?
- Have you noticed any unwanted change in weight?
- Have you noticed any changes in digestion?
- Diarrhea?
- Noticeably dark discolored stool?
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
- Do you engage in intense daily exercise (intense jogging or intense marches)?
Self anamnesis incl. medication anamnesis
- Pre-existing conditions (chronic diseases, bleeding, blood disorders, liver disease, kidney disease, bleeding abnormalities/cycle abnormalities).
- Pregnancy?
- Surgery (resection of stomach or small intestine; blood loss?).
- Frequent blood donation?/own blood treatment?
- Allergies
- Environmental history
Medication history
Anemia
- Antiprotozoal drugs
- Analogue of the azo dye trypan blue (suramin).
- Pentamidine
- Chelating agents (D-penicillamine, trieethylenetetramine dihydrochloride (Trien), tetrathiomolybdenum).
- Direct factor Xa inhibitor (rivaroxaban).
- Immunosuppressants (thalidomide).
- Janus kinase inhibitors (ruxolitinib).
- Monoclonal antibodies – pertuzumab
- MTOR inhibitors (everolimus, temsirolimus).
- Phenytoin [megaoblastic anemia.]
- Thrombin inhibitor (dabigatran)
- Antivirals
- Nucleoside analogues (ribavirin) [hemolytic anemia.]
- NS5A inhibitors (daclatasvir).
- Protease inhibitors (boceprevir, telaprevir).
Aplastic anemia
- Allopurinol*
- Alpha-methyldopa*
- Antibiotics – drugs such as streptomycin* , tetracycline* or methicillin* .
- Antidiabetic drugs – tolbutamide and chlorpropamide.
- Antihistamines – cimetidine
- Anticonvulsants – carbomazepine
- Carboanhydrase inhibitors (CAH, CAI) – acetazolamide, dichlorophenamide, methazolamide.
- Quinidine*
- Chloramphenicol
- D-Penicillamine – drug used in the therapy of rheumatoid arthritis.
- Lithium*
- Medicines for protozoan infections such as chloroquine or mepacrine.
- Non-steroidal anti-inflammatory drugs (NSAIDs) – phenylbutazone, ibuprofen, or acetylsalicylic acid (ASA).
- Estrogens
- Sedatives – such as chlorpromazine* or meprobamate* .
- Sulfonamides
- Thyrostatic agents – such as methylthiouracil or carbimazole.
- Cytostatics
- Alkylants such as chlorambucil or cyclophosphamide.
- Antimetabolites such as mercaptopurine, fluorouracil or methotrexate.
- Mitotic inhibitors such as vincristine or paclitaxel.
Note: For drugs marked with an asterisk (* ), the association with aplastic anemia is poorly documented. Furthermore, all drugs that can lead to gastrointestinal bleeding and generally increased bleeding tendency.
