What is the diagnosis for a patient with a Complete Blood Count (CBC) showing hypochromic anemia, hemoglobin (Hgb) of 10.8, Mean Corpuscular Hemoglobin (MCH) of 25, Mean Corpuscular Hemoglobin Concentration (MCHC) of 29, Red Cell Distribution Width (RDW) of 16.40, thrombocytosis with a platelet count of 414, iron level of 35, Total Iron Binding Capacity (TIBC) of 381, and iron percent saturation of 9, with a blood smear indicating mild anisocytosis?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 8, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Hypochromic Anemia

Single Most Likely Diagnosis

  • Iron Deficiency Anemia: The patient's iron level is low (35), and the iron binding capacity is high (381), resulting in a low iron percent saturation (9%). The blood smear shows hypochromic anemia with anisocytosis, which is consistent with iron deficiency anemia. The MCH (25) and MCHC (29) values are also low, supporting this diagnosis.

Other Likely Diagnoses

  • Chronic Disease Anemia: The patient's iron level is low, but the iron binding capacity is also elevated, which can be seen in chronic disease anemia. However, the blood smear and other laboratory values are more suggestive of iron deficiency anemia.
  • Thalassemia Trait: The patient's MCH (25) and MCHC (29) values are low, which can be seen in thalassemia trait. However, the RDW (16.40) is not as elevated as typically seen in thalassemia trait.
  • Anemia of Chronic Kidney Disease: The patient's iron level is low, and the iron binding capacity is elevated, which can be seen in anemia of chronic kidney disease. However, there is no other information provided to support this diagnosis.

Do Not Miss Diagnoses

  • Sideroblastic Anemia: This is a rare condition, but it can present with hypochromic anemia and low iron percent saturation. It is essential to consider this diagnosis to avoid missing a potentially treatable condition.
  • Lead Poisoning: Lead poisoning can cause hypochromic anemia, and it is essential to consider this diagnosis, especially in patients with occupational or environmental exposure to lead.

Rare Diagnoses

  • Pyrroloxine-Responsive Anemia: This is a rare condition that responds to vitamin B6 supplementation. It can present with hypochromic anemia and low iron percent saturation.
  • X-Linked Sideroblastic Anemia: This is a rare genetic disorder that can present with hypochromic anemia and low iron percent saturation. It is essential to consider this diagnosis in male patients with a family history of anemia.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.