Differential Diagnosis for Anemia with MCHC 30 and MCV 85

• Single most likely diagnosis:
  • Hypochromic microcytic anemia: This diagnosis is the most likely because the Mean Corpuscular Hemoglobin Concentration (MCHC) is low (normal range is approximately 34-36 g/dL), indicating that the red blood cells have less hemoglobin than normal (hypochromic), and the Mean Corpuscular Volume (MCV) is slightly below the normal range (normal range is approximately 80-100 fL), indicating that the red blood cells are smaller than normal (microcytic). Common causes include iron deficiency anemia, thalassemia, and anemia of chronic disease.
• Other Likely diagnoses:
  • Iron deficiency anemia: Given the low MCHC, iron deficiency is a strong consideration as it leads to hypochromic anemia. The MCV of 85, while on the lower end of normal, can be seen in early or mild iron deficiency anemia.
  • Thalassemia trait: This can present with microcytic anemia (low MCV) and often has a normal or slightly low MCHC. However, the MCHC can sometimes be at the lower end of the normal range or slightly below it.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Sideroblastic anemia: Although less common, this condition can present with microcytic hypochromic anemia and is important to consider due to its association with myelodysplastic syndromes and other significant health implications.
  • Lead poisoning: Can cause microcytic hypochromic anemia and is crucial to diagnose due to its potential for severe and long-lasting health effects, including neurological damage.
• Rare diagnoses:
  • Congenital dyserythropoietic anemia: A group of rare genetic disorders characterized by ineffective erythropoiesis and can present with varying degrees of anemia, including microcytic hypochromic anemia.
  • Other rare genetic disorders affecting hemoglobin synthesis or red blood cell production, which might present with abnormal MCHC and MCV values.