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Diagnosis
Diagnosis of normocytic anemia proves to be challenging as it is a clinical presentation for numerous other disease states.

The first steps in evaluating the potential for anemia is assessing the patient's medical history and completing a physical examination. This approach will allow for a streamlined evaluation where some causative agents can be ruled out.

Generally, a peripheral blood smear is completed to assess red blood cell appearance. The findings of a peripheral blood smear may include: spherocytes (hereditary spherocytosis anemia, autoimmune hemolysis, G6PD deficiency), red blood cells with a nucleus present (hemolytic anemia), large and small red blood cells present that may signify a mixture of microcytic and macrocytic anemias. Other findings may bite or blister cells, burr cells or shift cells.

To help with determining the underlying cause of the normocytic anemia, a complete blood count which includes the reticulocyte count, should be completed. A reticulocyte count that is high, normal or low will aid with the classification process and signify if the bone marrow is functioning properly. A low reticulocyte count may suggest there is suppression at the level of the bone marrow which produce the stem cells, bone marrow inadequacy or aplastic anemia. A high reticulocyte count signifies that bone marrow processes are normal. Acute blood loss or hemolysis would result in a high reticulocyte count as bone marrow processes are normal and the bone marrow responds accordingly to the body's need for blood.

Various other measures may be taken like screening for chronic conditions such as liver or kidney disease. Renal insufficiency may be suggested by an elevated creatinine level. A bone marrow biopsy is needed to confirm an aplastic anemia diagnosis.

Treatment
Applicable to every patient, treatment should include adequate nutrition and supportive care. Ultimately, treatment will depend on the cause of the normocytic anemia. Treatment for anemia due to chronic diseases, such as kidney disease, focus on healing and optimizing the primary condition first. Dietary foods or supplements should be added if anemia is due to a lack of a particular vitamin. Erythropoietin may be considered if anemia is severe. Human erythropoietin is indicated for anemia of renal disease. Erythropoietin will stimulate the bone marrow to produce more blood cells.