What is the interpretation of a Complete Blood Count (CBC) showing elevated Red Blood Cell (RBC) count, normal Hemoglobin (Hb) level, normal Hematocrit (Hct) level, low Mean Corpuscular Volume (MCV), low Mean Corpuscular Hemoglobin (MCH), and low Mean Corpuscular Hemoglobin Concentration (MCHC)?

From the Guidelines

This CBC shows microcytic hypochromic anemia with an elevated red blood cell count, suggesting a compensatory increase in red cell production, and is most likely due to iron deficiency anemia or thalassemia, as indicated by the low MCV, MCH, and MCHC values 1. The high RBC count (5.60 x10^6/uL) with normal hemoglobin (13.0 g/dL) and hematocrit (41.8%) suggests a compensatory increase in red cell production.

• The low MCV (75 fL), MCH (23.2 pg), and MCHC (31.1 g/dL) indicate that the red blood cells are smaller than normal and contain less hemoglobin than they should.
• This pattern is typically seen in iron deficiency anemia or thalassemia, with iron deficiency being a common cause of microcytic anemia, as noted in a study published in the Journal of the National Comprehensive Cancer Network 1.
• Iron deficiency would require iron supplementation (typically ferrous sulfate 325 mg daily for 3-6 months), while thalassemia is a genetic condition requiring different management.
• Further testing including iron studies, hemoglobin electrophoresis, and possibly a peripheral blood smear would help distinguish between these possibilities, as recommended in the European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases 1. The normal hemoglobin level suggests this is a mild case, but addressing the underlying cause is important to prevent progression of anemia and associated symptoms like fatigue and reduced exercise tolerance, as highlighted in a study on recommendations and nutritional considerations for female athletes 1.

From the Research

CBC Results Interpretation

The provided CBC results show the following values:

• RBC: 5.60 (x10E6/uL)
• Hemoglobin: 13.0 (g/dL)
• Hematocrit: 41.8 (%)
• MCV: 75 (fL)
• MCH: 23.2 (pg)
• MCHC: 31.1 (g/dL)

Microcytic Anemia Indicators

The MCV value of 75 fL is below the normal range of 79-97 fL, indicating microcytic anemia 2, 3. Microcytic anemia is characterized by small, often hypochromic, red blood cells. The most common cause of microcytic anemia is iron deficiency anemia 2, 3.

Key Findings

• Low MCV value suggests microcytic anemia
• Low MCH value of 23.2 pg, which is below the normal range of 26.6-33.0 pg
• Low MCHC value of 31.1 g/dL, which is below the normal range of 31.5-35.7 g/dL

Possible Causes

The causes of microcytic anemia include:

• Iron deficiency anemia 2, 3
• Thalassemia 3, 4
• Sideroblastic anemia 3
• Combined iron and vitamin B12 deficiency 5 Further testing, such as serum ferritin measurement and genetic analysis, may be necessary to determine the underlying cause of the microcytic anemia 2, 4.