What is the diagnosis for a patient with a complete blood count (CBC) showing normal hemoglobin (Hb) and hematocrit (Hct), increased red blood cell (RBC) count, microcytosis (low Mean Corpuscular Volume (MCV)), hypochromia (low Mean Corpuscular Hemoglobin (MCH) and low Mean Corpuscular Hemoglobin Concentration (MCHC)), and elevated Red Cell Distribution Width (RDW)?

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Differential Diagnosis for Abnormal CBC Results

Single Most Likely Diagnosis

  • Iron Deficiency Anemia: This is the most likely diagnosis given the low MCV, MCH, and MCHC values, which indicate microcytic hypochromic anemia. The elevated RDW suggests a variation in red blood cell size, which is consistent with iron deficiency anemia.

Other Likely Diagnoses

  • Thalassemia: This genetic disorder can cause microcytic hypochromic anemia, and the normal hemoglobin and hematocrit levels do not rule it out. The elevated RDW can also be seen in thalassemia.
  • Anisopoikilocytosis: This condition is characterized by a variation in red blood cell size and shape, which can cause an elevated RDW. The low MCV, MCH, and MCHC values can also be seen in this condition.
  • Chronic Disease: Chronic diseases such as chronic kidney disease or chronic inflammation can cause microcytic hypochromic anemia, and the elevated RDW can be seen in these conditions.

Do Not Miss Diagnoses

  • Sideroblastic Anemia: This rare condition can cause microcytic hypochromic anemia, and the elevated RDW can be seen in this condition. Sideroblastic anemia can be caused by genetic mutations, exposure to certain toxins, or other underlying conditions.
  • Myelodysplastic Syndrome: This group of disorders can cause abnormal red blood cell production, leading to microcytic hypochromic anemia and an elevated RDW. Myelodysplastic syndrome can progress to acute myeloid leukemia if left untreated.

Rare Diagnoses

  • Hemoglobinopathy: Certain hemoglobinopathies, such as hemoglobin E or hemoglobin C, can cause microcytic hypochromic anemia and an elevated RDW.
  • Red Blood Cell Membrane Disorders: Disorders such as hereditary spherocytosis or hereditary elliptocytosis can cause microcytic hypochromic anemia and an elevated RDW.
  • Copper Deficiency: Copper deficiency can cause microcytic hypochromic anemia, and the elevated RDW can be seen in this condition. Copper deficiency is rare but can be caused by certain genetic disorders or nutritional deficiencies.

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.

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