Normocytic Anemia

  • Normocytic Anemias are a categorization of anemias defined as those anemias which display normal-sized erythrocytes (i.e. Normal Mean Corpuscular Volume or MCV) and low reticulocyte counts. In general, normocytic anemias are caused by failure of the bone marrow to conduct proper hematopoiesis; consequently, normocytic anemias typically occur in the context of an overall pancytopenia. Failure of the bone marrow may be due to inherent defects of the marrow itself as in aplastic anemia and the myelodysplastic syndromes, or may be due to exogenous infiltration of the bone marrow by malignant cells or infectious organisms (myelophthisic anemia).
  • However, in those with chronic renal failure, normocytic anemia may arise due to reduced erythropoietin production by the kidneys. It is also important to note that patients with acute red cell loss due to either hemolytic anemias or a major hemorrhage will display a normocytic anemia; however, these are distinguished by a concomitant reticulocytosis that would send the workup down a different arm of the anemia algorithm (see page). Finally, anemia of chronic disease can be normocytic in some patients and should be included in the normoctyic anemia differential diagnosis.
  • Because the causes of normocytic anemias are better categorized under other sections of this text, we only place the differential diagnosis of normocytic anemia below. Clicking on these links may take you to distant sections within the table of contents.
Differential Diagnosis