From the Guidelines
This CBC is indicative of microcytic, hypochromic anemia with anisocytosis, likely due to iron deficiency anemia, and further testing is recommended to confirm the diagnosis and rule out other causes, such as thalassemia or anemia of chronic disease. The low Mean Corpuscular Hemoglobin (MCH) of 25.8 pg and low Mean Corpuscular Hemoglobin Concentration (MCHC) of 30.5 g/dL, as noted in the study by 1, suggest decreased hemoglobin content in each red blood cell, which is a hallmark of iron deficiency anemia. The elevated Red Cell Distribution Width (RDW) of 17.0% indicates significant variation in red blood cell size, which is also consistent with iron deficiency anemia.
According to the guidelines for the management of iron deficiency anemia in adults, as outlined in the study by 1, serum ferritin is the most specific test for iron deficiency in the absence of inflammation, and a level of <15 μg/L is indicative of absent iron stores. However, in the context of an inflammatory disease process, an SF cut-off of 45 μg/L has been suggested as providing the optimal trade-off between sensitivity and specificity for iron deficiency.
Some key points to consider in the diagnosis and management of iron deficiency anemia include:
- Microcytosis and hypochromia are common features of iron deficiency anemia, but can also occur in other conditions, such as thalassemia or anemia of chronic disease, as noted in the study by 1
- Serum iron, total iron binding capacity, and ferritin levels can help confirm the diagnosis of iron deficiency anemia
- Hemoglobin electrophoresis may be recommended to rule out thalassemia or other hemoglobinopathies, particularly in individuals with microcytosis and normal iron studies, as suggested by 1
- Oral iron supplementation, such as ferrous sulfate 325 mg daily, is typically prescribed for iron deficiency anemia, along with investigation of the underlying cause of iron deficiency.
Overall, further testing is necessary to confirm the diagnosis and determine the underlying cause of the anemia, and treatment should be guided by the results of these tests, as well as the patient's clinical presentation and medical history, as recommended by 1.
From the Research
Interpretation of CBC Results
The provided CBC results show:
- MCH (Mean Corpuscular Hemoglobin) of 25.8 pg, which is lower than the normal range of 26.6-33.0 pg 2, 3
- MCHC (Mean Corpuscular Hemoglobin Concentration) of 30.5 g/dL, which is lower than the normal range of 31.5-35.7 g/dL 2, 3
- RDW (Red Blood Cell Distribution Width) of 17.0%, which is higher than the normal range of 11.7-15.4% 3, 4
Possible Causes of Abnormal Results
Based on the studies, the abnormal results may indicate:
- Iron deficiency anemia, which is the most common cause of microcytic anemia 2, 3
- Other possible causes of microcytic anemia, such as anemia of chronic disease, thalassemia, and sideroblastic anemia 2
- Increased RDW may indicate a variation in red blood cell size, which can be seen in iron deficiency anemia, vitamin B12 or folate deficiency, and other conditions 3, 4
Further Evaluation and Testing
To determine the cause of the abnormal results, further evaluation and testing may be necessary, including: