Normally the red blood cell volume histogram shows a single peak. Sometimes two or more peaks may be seen.
Smaller Peak
Larger Peak
Interpretation
microcytic
normocytic
microcytic anemia after blood transfusion
macrocytic
microcytic anemia with marked reticulocytosis following therapy
macrocytic anemia after blood transfusion; normocytic anemia with marked reticulocytosis following therapy
macrocytic anemia with marked reticulocytosis following therapy
very microcytic and slurred
any
red blood cell fragmentation (hemolytic anemia)
Key questions to ask when evaluating the patient:
(1) Does the patient have a history of microcytic, normocytic or macrocytic anemia?
(2) If so, has the patient recently received specific therapy for the anemia?
(3) What is the patient's reticulocyte count?
(4) Has the patient been recently transfused?
(5) Is there evidence of a hemolytic anemia?
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Specialty: Hematology Oncology, Clinical Laboratory
