• A Schop, K Stouten, J A Riedl, R J van Houten, M J G Leening, J van Rosmalen, BindelsP J EPJEDepartment of General Practice, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands., and M-D Levin.
• Department of Internal Medicine, Albert Schweitzer Hospital, Postbus 444, 3300, AK, Dordrecht, the Netherlands. a.schop2@asz.nl.
• Bmc Fam Pract. 2020 Aug 16; 21 (1): 167.

BackgroundTo study etiologies of anemia using an extensive laboratory analysis in general practices.MethodAn extensive laboratory analysis was performed in blood of newly diagnosed anemia patients aged ≥50 years from the general population in the city of Dordrecht area, the Netherlands. Eight laboratory-orientated etiologies of anemia were defined. Patients were assigned one or more of these etiologies on the basis of their test results.ResultsBlood of 4152 patients (median age 75 years; 49% male) was analyzed. The anemia etiology was unclear in 20%; a single etiology was established in 59%; and multiple etiologies in 22% of the patients. The most common etiologies were anemia of chronic disease (ACD) (54.5%), iron deficiency anemia (IDA) (19.1%) and renal anemia (13.8%). The most common single etiologies were IDA (82%) and ACD (68%), while the multiple etiologies most commonly included folic acid deficiency (94%) and suspected bone marrow disease (88%). Older age was associated with a lower incidence of IDA and a higher incidence of renal anemia. Mild anemia was more often associated with ACD and uncertain anemia, while severe anemia was mainly seen in patients with IDA.ConclusionExtensive laboratory analysis in anemic patients from the general population helped clarify the etiology of anemia and revealed many various combinations of etiologies in a significant proportion of patients. Age, sex and the severity of anemia are predictive of the underlying etiology.

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