CONSULT REQUEST GUIDELINES                                                                         Print

Anemia: Hgb < 11.0 gm/dl and MCV <80 fl

Suggested Pre-Referral Evaluation and Management Guidelines

Obtain CBC, platelet count, reticulocyte count; serum iron (Fe) and total iron binding capacity (TIBC), serum ferritin.

If serum Fe/TIBC ratio is < 10% and/or serum ferritin < 12 ug/ml, evaluate patient for GI blood loss (stool blood, upper endoscopy, and colonoscopy) and menstrual history before hematology consultation.

If normal or elevated serum iron and total iron binding capacity and serum ferritin, obtain a hemoglobin electrophoresis and/or consider alpha globin chain analysis which is done as send out to Mayo medical labs to exclude thalassemia traits in African Americans, Asians, Asian Indian populations, before referral to hematology.

Suggested Additional Test/Management Prior to Specialty Visit

If the patient has a GI or gyn reason for blood loss, after treatment for the underlying etiology of blood loss, the patient needs 3 months of oral iron therapy (ferrous sulfate 300 mg po TID X 3 months, ferrous gluconate, or ferrous fumarate formulations) prior to a hematology referral.

If all of the previous is done and the patient remains anemic, schedule a consult with hematology faculty who see benign disorders.

Patient Education/Information (includes preps) CBC
What is Anemia
Appointment Timeframe Next Available Appointment
How to Get Results to Consultant UMHS Patients: See MiChart
External Patients: Hand carry reports and clinic notes to visit
Clinic Contact Information Physicians: 800-962-3555
Patients: 734-647-8901 (Main Line)
              734-647-8915 (Clinic Coordinator)
Clinic Location Sites Cancer Center (All new appointments made through Cancer Center)
UM Consulting Physician

Asra Z. Ahmed, M.D.
Paula L. Bockenstedt, M.D.
Scott D. Gitlin, M.D.
Mark S. Kaminski, M.D.
Lisa A. Kujawski, M.D.
Sami N. Malek, M.D.
Samuel M. Silver, M.D.
Moshe Talpaz, M.D.
Steven W. Pipe, M.D.
Jordan Shavit, M.D.

Revised on: 09/10/2014



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