Interpretation of CBC Blood Report
The provided CBC (Complete Blood Count) report shows:
- Hemoglobin (Hb): 11 g/dL
- Packed Cell Volume (PCV) or Hematocrit (Hct): 35%
- Mean Corpuscular Volume (MCV): 69 fL
- Mean Corpuscular Hemoglobin (MCH): 21 pg
- Total Leukocyte Count (TLC): 15,400 cells/μL
- Polymorphonuclear cells (Polymorphs or Neutrophils): 88%
- Lymphocytes: 6%
Differential Diagnosis
Single Most Likely Diagnosis
- Iron Deficiency Anemia: The low MCV (69 fL) indicates microcytic anemia, and the low Hb (11 g/dL) and PCV (35%) support anemia. Iron deficiency is a common cause of microcytic anemia.
Other Likely Diagnoses
- Chronic Disease Anemia: Conditions like chronic infections, inflammatory diseases, or malignancies can cause microcytic anemia due to chronic inflammation.
- Thalassemia Trait: This genetic disorder can also present with microcytic anemia, although the MCH and MCV would typically be lower than in iron deficiency anemia.
- Anemia of Chronic Kidney Disease: If the patient has kidney disease, this could be a cause of microcytic anemia, though it's less common than iron deficiency.
Do Not Miss Diagnoses
- Sideroblastic Anemia: A rare condition where the bone marrow fails to utilize iron to create hemoglobin, leading to microcytic anemia. It's crucial to diagnose due to its implications for treatment and potential association with myelodysplastic syndromes.
- Lead Poisoning: Can cause microcytic anemia and is critical to diagnose due to its toxic effects on multiple organ systems.
Rare Diagnoses
- Congenital Disorders of Iron Metabolism: Rare genetic conditions affecting iron metabolism, such as atransferrinemia or ceruloplasmin deficiency, which can lead to microcytic anemia.
- Hemoglobinopathies: Certain hemoglobinopathies can present with microcytic anemia, though they are less common and often have distinctive features on hemoglobin electrophoresis.
Treatment
Treatment will depend on the underlying cause of the microcytic anemia. For Iron Deficiency Anemia, oral iron supplementation is the first line of treatment. For other causes, treatment will be directed at the underlying condition (e.g., treating chronic disease, managing thalassemia trait, addressing kidney disease). In all cases, a thorough diagnostic workup is necessary to guide appropriate therapy.