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CPE-011 · synthetic case ANEM-FX-23

Severe anemia with dyspnea

Hb 7.6 with symptoms.

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

Purpose: Hb 7.6 with symptoms.

Inputs the engine received

CBC and reticulocytes

Hemoglobin
7.6 g/dL
MCV
80 fL

Patient

Age
63 years
Sex
Female
Chest pain, dyspnea at rest or syncope
Yes

Iron, vitamins and inflammation

Ferritin
15 ng/mL

What the engine reports

Detected clinical pattern

Urgent Review Finding

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

  • Severity: Severe anemia (Hb 7.6 g/dL)
  • Morphology: Normocytic (MCV 80–100)
  • Pattern: iron deficiency pattern anemia

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Urgent clinical assessment of severe anemia.
  2. 2Establish the source of iron loss or poor absorption; the Iron Deficiency Pattern Engine applies the gastrointestinal-evaluation rules.

Missing information

  • Reticulocyte percentage with hematocrit (marrow response).
Evidence and rule trace · 5 rules

AN-01Anemia present, with severity

Inputs: hemoglobin 7.6 g/dL (<12)

Anemia, severe.

AN-02Morphology by MCV

Inputs: MCV 80 fL

Normocytic anemia.

AN-10Iron-deficiency pattern

Inputs: ferritin 15 ng/mL

Pattern compatible with iron deficiency.

AN-SAFE-01Severe anemia

Inputs: hemoglobin 7.6 g/dL · with chest pain, dyspnea at rest or syncope

Urgent clinical assessment: severe anemia.

AN-MISS-01Information needed

Inputs: Reticulocyte percentage with hematocrit

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-CAMASCHELLA-2015 · Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832-1843.

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.

Change the values

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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: Severe anemia (Hb 7.6 g/dL)
  • Morphology: Normocytic (MCV 80–100)
  • Pattern: iron deficiency pattern anemia

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Urgent clinical assessment of severe anemia.
  2. 2Establish the source of iron loss or poor absorption; the Iron Deficiency Pattern Engine applies the gastrointestinal-evaluation rules.

Missing information

  • Reticulocyte percentage with hematocrit (marrow response).
Evidence and rule trace · 5 rules

AN-01Anemia present, with severity

Inputs: hemoglobin 7.6 g/dL (<12)

Anemia, severe.

AN-02Morphology by MCV

Inputs: MCV 80 fL

Normocytic anemia.

AN-10Iron-deficiency pattern

Inputs: ferritin 15 ng/mL

Pattern compatible with iron deficiency.

AN-SAFE-01Severe anemia

Inputs: hemoglobin 7.6 g/dL · with chest pain, dyspnea at rest or syncope

Urgent clinical assessment: severe anemia.

AN-MISS-01Information needed

Inputs: Reticulocyte percentage with hematocrit

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-CAMASCHELLA-2015 · Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832-1843.

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%.

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