Anemia causes a reduced red blood cell volume (hematocrit) or a reduced concentration of blood hemoglobin. A physical examination should be done in case of unexplained anemia because test results for anemia are altered by chronic lung disease, dehydration and congestive heart failure.

The causes of anemia include genetics, chronic blood loss, alcohol toxicity and medication use. Patients may not notice slow blood loss from the gastrointestinal tract. Chronic inflammatory, kidney, thyroid and liver diseases can also cause anemia.

The mean corpuscular volume (MCV) is the size of the average red blood cell of a sample. Abnormally small cells are microcytic and large cells are macrocytic. The mean corpuscular hemoglobin concentration (MCHC) refers to the amount of hemoglobin in the average cell of a sample and cells that are low in hemoglobin are hypochromic. Microcytic, hypochromic anemia can be caused by lead toxicity, chronic disease, thalassemia and hemoglobin E disorder.
Iron deficiency is the most common cause of microcytic, hypochromic anemia. Ferritin blood levels are a measure of the body’s stores of iron and are usually low in iron deficiency anemia. Serum ferritin levels can be normal in iron deficiency anemia, which coexists with chronic inflammatory diseases, chronic infections or malignancy. Following the patient’s cellular response to iron therapy can help make the proper diagnosis. In treating iron deficiency, 6 mg/kg/day up to 200 mg/day of elemental iron is given. Hg concentration can be checked in a few weeks or serum reticulocyte (immature red cell) counts can be done in a few days.

Failure to respond to iron therapy means that the person has another cause of anemia or there is iron mal-absorption (such as in sprue). Iron deficiency in infancy and childhood is nearly always due to low intake and older adults with unexplained iron deficiency should have a complete gastrointestinal evaluation.

CONCLUSION: Microcytic, hypochromic anemia can be caused by iron deficiency and other causes as listed above.

NOTE: Read about the way that copper deficiency can mascarade as iron deficiency anemia.

To read the author’s abstract of the article click on the link to the author’s title of the article above.

PMID: 2020645.

Summary #240.