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Test Code ANECAS ANEMIA CASCADE

Important Note

This test is intended for patients over 18 years old with unexplained anemia.  For outpatient use only.

The cascade begins with a complete blood count (CBC), differential, and reticulocyte battery. If the patient’s hemoglobin is below the reference interval, additional testing will be performed as determined by the mean corpuscular volume (MCV). See the table below for a description of the additional testing that may be performed on the sample based on the MCV and other parameters.

Microcytic Normocytic Macrocytic

If Reticulocyte Hemoglobin is not decreased: Creatinine will be reflexed.

If Reticulocyte Hemoglobin is decreased:  Iron Saturation and Ferritin will be reflexed.

If Ferritin is not decreased: Creatinine will be reflexed.

 

If reticulocyte count is not increased and the Reticulocyte Hemoglobin is not decreased: Creatinine will be reflexed.

If reticulocyte count is not increased and the Reticulocyte Hemoglobin is decreased: Iron Saturation and Ferritin will be reflexed.

If reticulocyte count is increased: LDH and haptoglobin will be reflexed.

If LDH is increased and the haptoglobin is decreased: DAT will reflex.
 

If reticulocyte count is not elevated: Vitamin B12 will be reflexed.

If B12 is not decreased: TSH, ALT, AST will be reflexed.

If reticulocyte count is increased: LDH and haptoglobin will be reflexed.

If LDH is increased and the haptoglobin is decreased: DAT will reflex.
 

Additional Codes

Orderable Codes:

Epic Code Atlas Code Mayo Access ID Order LOINC Legacy Code
LAB9895 N/A N/A N/A ANECAS

 

Specimen Information

Container Specimen Temperature Collect Vol Submit Vol Min Vol
SST Serum Refrigerate 8 mL 3 mL 3 mL
*Lav Top (EDTA) Whole Blood Refrigerate 3.5 mL 3.5 mL 3.5 mL

*Invert tube gently 10 times.

 

Test Schedule / Analytical Time / Test Priority

Daily / Up to 3 days depending on the reflexed testing /  Not available STAT

Performing Location

University of Vermont Medical Center

Is the UVMMC lab NY State Certified to perform this testing?  Yes/No

Yes