What is the diagnosis for a patient with microcytosis (low Mean Corpuscular Volume (MCV) of 69), increased red cell distribution width (RDW) of 17.9, normal red blood cell (RBC) count of 6.2, low mean corpuscular hemoglobin (MCH) of 21, and low mean corpuscular hemoglobin concentration (MCHC) of 30.5?

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: March 31, 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 the Given Blood Parameters

The provided blood parameters are:

  • MCV (Mean Corpuscular Volume): 69 fl
  • RDW (Red Cell Distribution Width): 17.9%
  • RBC Count: 6.2 million/μL
  • MCH (Mean Corpuscular Hemoglobin): 21 pg
  • MCHC (Mean Corpuscular Hemoglobin Concentration): 30.5 g/dL

Single Most Likely Diagnosis

  • Iron Deficiency Anemia: This is the most likely diagnosis given the low MCV (indicating microcytic anemia), low MCH and MCHC (indicating hypochromia), and elevated RDW (indicating a variation in red blood cell size, which is common in iron deficiency anemia). The RBC count is slightly elevated, which can occur in iron deficiency anemia as the body tries to compensate for the lack of oxygen delivery.

Other Likely Diagnoses

  • Thalassemia Trait: This condition can also present with microcytic anemia (low MCV), but typically the RDW is not as elevated as in iron deficiency anemia. The MCH and MCHC are also low, consistent with thalassemia trait. However, the RBC count is often higher in thalassemia trait than in iron deficiency anemia.
  • Chronic Disease Anemia: This can also cause microcytic anemia with low MCH and MCHC. However, the RDW might not be as elevated as in iron deficiency anemia, and the clinical context (e.g., presence of chronic disease) would be important for differentiation.

Do Not Miss Diagnoses

  • Sideroblastic Anemia: Although less common, this condition can cause microcytic anemia with elevated RDW and low MCH and MCHC. It's crucial to consider this diagnosis because it can be associated with myelodysplastic syndromes or other significant underlying conditions.
  • Lead Poisoning: Lead poisoning can cause microcytic anemia with basophilic stippling of red blood cells. Although the parameters alone do not specifically point to lead poisoning, it's a critical diagnosis not to miss due to its potential for severe health consequences.

Rare Diagnoses

  • Congenital Disorders of Hemoglobin Synthesis: These are rare conditions that can cause microcytic anemia, such as congenital sideroblastic anemia. They are typically diagnosed at a young age and have specific genetic and clinical features.
  • Hemoglobinopathies: Certain hemoglobinopathies can present with microcytic anemia, although they are less common and often have distinctive clinical and laboratory features that aid in their diagnosis.

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.