II. Causes
-
Iron Deficiency Anemia (most common)
- Decreased Serum Iron level
- Increased Total Iron Binding Capacity
- Decreased Transferrin Saturation
-
Thalassemia
- Normal iron studies
- Differentiated with Hemoglobin electrophoresis
-
Anemia of Chronic Disease
- Decreased Serum Iron, TIBC and Transferrin Saturation
-
Sideroblastic Anemia
- Similar workup as with Thalassemia
- Lead Poisoning
- Copper Deficiency
- Zinc Toxicity
- Hemoglobinopathy
III. Labs
-
Complete Blood Count
- See Hemoglobin Cutoffs for Anemia
- See Hematocrit Cutoffs for Anemia
-
Mean Corpuscular Volume (MCV) <80
- See MCV Cutoffs for Microcytic Anemia
- MCV cutoff varies by age and per reference
-
Serum Iron
- Decreased in Iron Deficiency Anemia and Anemia of Chronic Disease
-
Total Iron Binding Capacity (TIBC)
- Increased in Iron Deficiency Anemia
- Decreased in Anemia of Chronic Disease
-
Transferrin Saturation
- Near complete saturation in Sideroblastic Anemia
- Less than 5% saturated in Iron Deficiency Anemia
-
Ferritin Level
- Ferritin <15 ng/ml suggests Iron Deficiency Anemia
- Ferritin is acute phase reactant and also elevated in chronic inflammation
- Use cutoff of <50 ng/ml to diagnose Iron Deficiency Anemia when comorbid inflammatory condition present
-
Reticulocyte Index <1% (Reticulocytopenia)
- See Anemia for causes of Reticulocytosis
-
Mean Corpuscular Volume to Red Blood Cell Count ratio
- See Mentzer Index
- Ratio <13: Thalassemia
- Ratio >13: Iron Deficiency Anemia, Hemoglobinopathy
IV. Labs: Hemoglobin Electrophoresis
- Indications
- Suspected Hemoglobinopathy (e.g. Thalassemia)
- Normal Serum Iron, Transferrin Saturation, and TIBC (esp. in young patients)
- Interpretation
- Increased Hemoglobin A2 Level
- Normal Hemoglobin A2 Level
- Sideroblastic Anemia
- Alpha-Thalassemia trait
V. References
Images: Related links to external sites (from Bing)
Related Studies
| Definition (CSP) | anemia featuring pale erythrocytes smaller than 6 microns in diameter; typically due to iron deficiency or abnormalities in hememetabolism. |
| Concepts | Disease or Syndrome (T047) |
| MSH | C536357 |
| SnomedCT | 191126000, 191130002, 44666001 |
| Dutch | hypochrome microcytaire anemie, hypochrome microcytische anemie, anemie hyperchroom macrocytair beeld, hypochrome microcytische beeldanemie, anemie; hypochroom, microcytair, anemie; microcytair, hypochroom |
| French | Anémie microcytaire hypochrome, Anémie - Tableau microcytaire hypochrome |
| German | hypochrom-mikrozytaere Anaemie, Anaemie-hypochrom-mikrozytaeres Bild |
| Italian | Anemia microcitica ipocromica, Anemia, quadro ipocromico microcitico |
| Portuguese | Anemia microcítica hipocrómica, Anemia hipocrómica com quadro microcítico |
| Spanish | Anemia. Imagen microcítica hipocrómica, Anemia hipocrómica microcítica, anemia hipocrómica microcítica [dup], anemia hipocrómica microcítica [dup] (trastorno), anemia hipocrómica microcítica, anemia microcítica hipocrómica (trastorno), anemia microcítica hipocrómica |
| Japanese | 貧血・低色素性小球像, 低色素性小球性貧血, ﾋﾝｹﾂﾃｲｼｷｿｾｲｼｮｳｷｭｳｿﾞｳ, ﾃｲｼｷｿｾｲｼｮｳｷｭｳｾｲﾋﾝｹﾂ |
| English | Hypochromic, microcytic anemia, hypochromic microcytic anemia (diagnosis), hypochromic microcytic anemia, hypochromic / microcytic anemia, Anaemia- Hypochromic microcytic picture, Anemia- Hypochromic microcytic picture, Microcytic, hypochromic anemia, Microcytic hypochromic anemia (disorder), Anemia, hypochromic microcytic, anemia microcytic hypochromic, anemias hypochromic microcytic, hypochromic microcytic anaemia, microcytic hypochromic anemia, microcytic hypochromic anaemia, microcytic/hypochromic anemia, Anemia, microcytic hypochromic, Microcytic - hypochromic anemia, Microcytic - hypochromic anaemia, Hypochromic - microcytic anaemia, Hypochromic - microcytic anemia, Hypochromic microcytic anemia, Microcytic hypochromic anemia, Hypochromic microcytic anaemia, Microcytic hypochromic anaemia, anemia; hypochromic, microcytic, anemia; microcytic, hypochromic, Microcytic hypochromic anemia [dup] (disorder) |
| Czech | Hypochromní mikrocytová anémie, Anémie hypochromní mikrocytová |
| Hungarian | hypochrom microcytaer anaemia, Hypochrom microcytás anaemia, Hypochrom microcytaer anaemia, hypochrom microcytás anaemia |
