From the Guidelines
The patient's blood test results indicate microcytic hypochromic anemia, characterized by low hemoglobin (9.6 g/dL), low hematocrit (31.1%), low MCV (79.3 fL), low MCH (24.5 pcg), and low MCHC (30.9 g/dL), which is typically seen in iron deficiency anemia, and treatment should focus on iron supplementation, as recommended by the NCCN clinical practice guidelines in oncology: myelodysplastic syndromes 1.
Key Findings
- Low hemoglobin (9.6 g/dL) and hematocrit (31.1%) indicate anemia
- Low MCV (79.3 fL), MCH (24.5 pcg), and MCHC (30.9 g/dL) suggest microcytic hypochromic anemia
- Elevated RDW (15.0%) indicates variation in red blood cell size, common in iron deficiency
- Normal white blood cell and platelet counts
- Differential count shows normal distribution of white blood cells
Recommended Treatment
- Iron supplementation, typically ferrous sulfate 325 mg daily or every other day, taken with vitamin C to enhance absorption and between meals to avoid interference from food
- Workup to determine the cause of iron deficiency, which may include evaluation for gastrointestinal blood loss, poor dietary intake, or malabsorption
- Follow-up testing in 4-6 weeks to monitor response to treatment
- Dietary counseling to increase iron-rich foods like lean red meat, beans, and leafy greens
Additional Evaluation
- Consider additional genetic screening for patients with familial cytopenias, as recommended by the NCCN guidelines 1
- Evaluate for other possible causes of cytopenias, such as concomitant medications and comorbid conditions, as suggested by the NCCN guidelines 1
From the Research
Blood Test Results Analysis
The provided blood test results show several abnormal values, including:
- Low Hemoglobin (9.6 g/dL)
- Low Hematocrit (31.1%)
- Low MCV (79.3 FL)
- Low MCH (24.5 pcg)
- High RDW (15.0%)
Possible Causes of Abnormal Results
Based on the studies 2, 3, 4, 5, 6, the abnormal results may indicate microcytic anemia, which is characterized by small red blood cells. The most common cause of microcytic anemia is iron deficiency anemia. Other possible causes include thalassemia, anemia of chronic disease, lead toxicity, and sideroblastic anemia.
Diagnostic Approach
To diagnose the cause of microcytic anemia, the following steps can be taken:
- Measure serum ferritin levels to check for iron deficiency 6
- Check for underlying sources of iron deficiency, such as gastrointestinal bleeding 6
- Evaluate total iron-binding capacity, transferrin saturation level, and serum iron level to differentiate between iron deficiency anemia and other causes of microcytic anemia 6
- Consider hemoglobin electrophoresis to diagnose thalassemia or other hemoglobinopathies 6
- Use reticulocyte hemoglobin content (CHr) as an early marker of iron deficient erythropoiesis and to monitor response to iron therapy 5
Key Findings
- Microcytic anemia is defined as anemia with a mean corpuscular volume (MCV) of less than 80 mcm3 in adults 4
- Iron deficiency anemia is the most common cause of microcytic anemia 2, 4
- Reticulocyte hemoglobin content (CHr) is a useful marker for diagnosing iron deficiency and monitoring response to iron therapy 5