Evaluation of aplastic anemia begins with a careful history and physical examination. A history of chemical or drug exposures is very important.

Physical findings in those with aplastic anemia may include:

• Decreased palmar creases
• Enlarged spleen
• Tenderness of the sternum
• Rapid or irregular heartbeat
• Heart murmur
• Limb swelling
• Leg swelling (bilateral)
• Low blood pressure

This diagnosis of aplastic anemia is confirmed through blood testing and bone marrow testing.

Tests for aplastic anemia may include:

• Stool guaiac
• Testing the stools for the presence of minute quantities of blood
• Complete blood count
• Platelet count
• Peripheral blood smear
• Reticulocyte count
• Serum ferritin level
• Serum iron level
• Kidney profile
• Erythropoietin level
• Total iron binding capacity
• Vitamin B-12 level
• Hemoglobin electrophoresis
• Coagulation profile
• Bone marrow biopsy
• CT scan of the abdomen:
• To check for enlarged spleen