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CPE-011 · synthetic case ANEM-FX-12

Melena and Hb 8.9

Overt gastrointestinal bleeding.

Synthetic · no real patientAuthored by Biod · reviewed by Dr. AmaralAnemia engine v1.0.0

Purpose: Overt gastrointestinal bleeding.

Inputs the engine received

CBC and reticulocytes

Hemoglobin
8.9 g/dL
MCV
82 fL

Patient

Age
66 years
Sex
Male
Melena, hematochezia or hematemesis
Yes

What the engine reports

Detected clinical pattern

Urgent Review Finding

A safety rule calls for urgent clinical assessment. Read the safety findings first.

  • Severity: Moderate anemia (Hb 8.9 g/dL)
  • Morphology: Normocytic (MCV 80–100)
  • Pattern: normo anemia unclassified

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Urgent assessment of a possible active gastrointestinal bleed.

Missing information

  • Reticulocyte percentage with hematocrit (marrow response).
  • Ferritin (and transferrin saturation).
Evidence and rule trace · 4 rules

AN-01Anemia present, with severity

Inputs: hemoglobin 8.9 g/dL (<13)

Anemia, moderate.

AN-02Morphology by MCV

Inputs: MCV 82 fL

Normocytic anemia.

AN-SAFE-04Overt gastrointestinal bleeding

Inputs: melena, hematochezia or hematemesis

Urgent assessment of a possible active GI bleed.

AN-MISS-01Information needed

Inputs: Reticulocyte percentage with hematocrit · Ferritin

First-line studies are incomplete.

Evidence

  • EV-WHO-HB-2011 · World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva: WHO; 2011.
  • EV-TEFFERI-2003 · Tefferi A. Anemia in adults: a contemporary approach to diagnosis. Mayo Clin Proc. 2003;78(10):1274-1280.
  • EV-AGA-2020 · Ko CW, Siddique SM, Patel A, et al. AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia. Gastroenterology. 2020;159(3):1085-1094.

Physician adjudication required. Clinical decision support for physician review. This output classifies anemia by morphology and marrow response and lists patterns and safety considerations. It does not diagnose a cause, rank causes by probability, or select treatment or transfusion. Physician adjudication is required.

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Morphology

  1. ✓ Microcytic

    MCV <80 fL

  2. ● Normocytic

    MCV 80–100 fL

  3. ○ Macrocytic

    MCV >100 fL

Marrow response (reticulocyte production index)

  1. ○ Inadequate · RPI <2

    Hypoproliferative: deficiency, inflammation, kidney, marrow

  2. ○ Appropriate · RPI ≥2

    Blood loss, hemolysis or recovery

No stage is assigned for the values entered.

CBC and reticulocytes
  • <7
  • 7–8
  • 8–11
  • 11–13
  • ≥13
Patient
Sex
Iron, vitamins and inflammation
Hemolysis, kidney and thyroid

250 U/L is assumed when empty.

Blood film and other context

Live result · computed in your browser

Detected clinical pattern

Urgent Review Finding

A safety rule calls for urgent clinical assessment. Read the safety findings first.

  • Severity: Moderate anemia (Hb 8.9 g/dL)
  • Morphology: Normocytic (MCV 80–100)
  • Pattern: normo anemia unclassified

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Urgent assessment of a possible active gastrointestinal bleed.

Missing information

  • Reticulocyte percentage with hematocrit (marrow response).
  • Ferritin (and transferrin saturation).
Evidence and rule trace · 4 rules

AN-01Anemia present, with severity

Inputs: hemoglobin 8.9 g/dL (<13)

Anemia, moderate.

AN-02Morphology by MCV

Inputs: MCV 82 fL

Normocytic anemia.

AN-SAFE-04Overt gastrointestinal bleeding

Inputs: melena, hematochezia or hematemesis

Urgent assessment of a possible active GI bleed.

AN-MISS-01Information needed

Inputs: Reticulocyte percentage with hematocrit · Ferritin

First-line studies are incomplete.

Evidence

  • EV-WHO-HB-2011 · World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva: WHO; 2011.
  • EV-TEFFERI-2003 · Tefferi A. Anemia in adults: a contemporary approach to diagnosis. Mayo Clin Proc. 2003;78(10):1274-1280.
  • EV-AGA-2020 · Ko CW, Siddique SM, Patel A, et al. AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia. Gastroenterology. 2020;159(3):1085-1094.

Physician adjudication required. Clinical decision support for physician review. This output classifies anemia by morphology and marrow response and lists patterns and safety considerations. It does not diagnose a cause, rank causes by probability, or select treatment or transfusion. Physician adjudication is required.

More anemia cases

ANEM-FX-01

Microcytic anemia with low ferritin

A 36-year-old, Hb 9.9, MCV 72, ferritin 6, TSAT 7%.

ANEM-FX-02

Microcytic anemia, normal iron indices and a low Mentzer index

MCV 62, RBC 5.7.

ANEM-FX-03

Macrocytic anemia with low B12 and hypersegmented neutrophils

MCV 112.

ANEM-FX-04

Hemolysis: reticulocytes 12%, LDH 640, haptoglobin 5

Spherocytes and a positive DAT.

ANEM-FX-05

Anemia in CKD

eGFR 28, normocytic, low reticulocytes, iron replete.

ANEM-FX-06

Anemia of inflammation

CRP 30, ferritin 340, TSAT 12%.

All anemia cases

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