Discriminant value of % microcytic/% hypochromic ratio in the differential diagnosis of microcytic anemia
. Clin Chem Lab Med 2008;46 (12):1752-8.
In Florida, our African American patients have a commonly found association with microcytic anemia
at least as often as iron deficiency: a variety of [alpha]- and [beta]-thalassemia traits that may occur individually or together.
The second most common type of anemia is microcytic anemia
due to iron deficiency and is largely due to malabsorption observed in hypothyroidism and menorrhagia occurring as a result of various hormonal instability.
Additionally, the patient's final blood analysis revealed hypochromic microcytic anemia
Lab results showed microcytic anemia
with hemoglobin of 6 g/dL, and thrombocytosis, with a platelet count of 512,000.
Laboratory exams revealed moderate hypochromic microcytic anemia
(Ht 28.1%, Hb 8.46 g/dL, MCV: 67.2, and MCH: 20.2), mild thrombocytosis (PLTs: 519 x 109/L), and leukocytosis: WBC 27 x 109/L (neu: 87%, lymph: 9%, and mono: 4%).
Laboratory findings showed a microcytic anemia
, a heterozygote [beta]-thalassemia, mild leukocytosis, and slight liver enzyme activity increases (Table 1, case 1).
. N Engl J Med 2014; 371(14):1324-1331.
Results: A total of one hundred and thirty-five individuals with hypochromic microcytic anemia
having normal hemoglobin F and hemoglobin A2 3.2% and having low serum iron and ferritin.4
Aguirre, "Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia
: a meta-analysis," Clinical Chemistry and Laboratory Medicine, vol.
When corrected for this difference, the residual share of microcytic anemia
, therefore estimated share of iron deficiency anemia was around 50%.
Laboratory abnormalities commonly include elevated inflammatory markers, microcytic anemia
, hypergammaglobulinemia, and hypoalbuminemia .
The laboratory evaluation revealed mild microcytic anemia
, a normal platelet count, and normal prothrombin time (PT) and activated partial thromboplastin time (aPTT).
In April 2014, patient was evaluated for dyspepsia and microcytic anemia
, for which an esophagogastroduodenoscopy (EGD) and colonoscopy were done.
Exploratory laboratory tests showed elevated lactate dehydrogenase (445 U/L), severe renal dysfunction (BUN 31.7 mmol/L, creatinine 236 [micro]mol/L), microcytic anemia
(Hb 6.1 mmol/L, MCV 77 fl), mild inflammation (CRP 88 mg/L), thrombocytopenia (124 x [10.sup.9]/L), and normal leukocyte count (9.0 x [10.sup.9]/L) with mild eosinophilia (990/[micro]L).