Clinical features

Possible symptoms include:

• pallor
• fatigue
• dyspnoea
• anorexia
• headache
• bowel disturbance
• features of underlying disease

Possible signs include:

• koilonychia is suggestive of iron deficiency
• conjunctival pallor suggests anaemia (1)
• combination of fair or prematurely grey hair and blue eyes may indicate pernicious anaemia
• gum hypertrophy may occur secondary to infiltration by leukaemic cells, especially in acute monocytic leukaemia
• atrophic glossitis may occur in megaloblastic anaemia or iron deficiency anaemia
• tachycardia
• wide pulse pressure
• systolic ejection murmur

Reference:

1. Tally N, O'Connor S. Clinical Examination. Blackwell Scientific Publications.