1st order laboratory parameters – obligatory laboratory tests.
- Small blood count [macrocytic hyperchromic anemia: MCV ↑ → macrocytic MCH ↑ → hyperchromic]
- Differential blood count
- Inflammatory parameters – ESR (erythrocyte sedimentation rate) or CRP (C-reactive protein).
- Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance).
- Iron
- Ferritin (iron storage protein)
- Folic acid [↓ in folic acid deficiency anemia].
- Vitamin B12 [↓ in pernicious anemia]
- Reticulocytes (“young erythrocytes”) [normal]
- Test for occult (not visible) blood in the stool.
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- In V. D. on pernicious anemia – determination of antibodies against parietal cells of the stomach (gastritis type A), as well as intrinsic factor important for vitamin B12 absorption. → Antiparietal cells (parietal cell antibodies (PCA)) (80-90% of cases), anti-intrinsic factor (intrinsic factor antibodies) (45-70% of cases).
- Thyroid parameters – TSH (thyroid-stimulating hormone).
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH), gamma-glutamyl transferase (γ-GT, gamma-GT; GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine.
- Bone marrow biopsy
