Microcytic anemia

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List of terms related to Microcytic anemia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Microcytic anemia is characterized by small red blood cells. The normal mean corpuscular volume (abbreviated to MCV on full blood count results) is 76-100 fl, with smaller cells (<76 fl) described as microcytic and larger cells (>100 fl) as macrocytic.

In microcytic anemia, the red blood cells (erythrocytes) are usually also hypochromic, meaning that the red blood cells are paler than usual. This can be quantified as the mean corpuscular hemoglobin or mean cell hemoglobin (MCH), the amount of hemoglobin per cell; the normal value is 27-32 picograms (pg). Similar is the mean corpuscular hemoglobin concentration or mean cell hemoglobin concentration (MCHC), giving the amount of hemoglobin per volume of erythrocytes (normally about 320-360 g/l or 32-36 g/dl). Typically, therefore, anemia of this category is described as "microcytic, hypochromic anemia".

Microcytic anaemia is classically caused by:

Other causes that are "typically" thought of as causing normocytic anemia or macrocytic anemia must also be considered, and the presence of two or more causes of anemia can distort the "typical" picture of each.

Differentiating Microcytic Anemia from Other Diseases

To review the differential diagnosis of anemia, click here.

Disease Genetics Clinical manifestation Lab findings
History Symptoms Signs Hemolysis Intrinsic/Extrinsic Hb concentration MCV RDW Reticulocytosis Haptoglobin levels Hepcidin Iron studies Specific finding on blood smear
Serum iron Serum Tfr level Transferrin or TIBC Ferritin Transferrin saturation
Iron deficiency anemia Hypochromic Microcytic Nl or ↓ Nl Nl ↓↓↓
Lead poisoning
  • House painted with chipped paint
Hypochromic Microcytic Nl Nl or ↓ Nl Nl Nl to ↓ Nl Nl Nl to ↓
  • RBCs retain aggregates of rRNA
  • Basophilic stippling
Sideroblastic anemia Hypochromic Microcytic Nl Nl or ↓ Nl Nl Nl Nl to ↓
Anemia of chronic disease Hypochromic Microcytic Nl Nl or ↓ Nl Nl NA
Thalassemia α-thalassemia
  • α- globin gene deletions
  • Cis deletions
  • Trans deletions

β-thalassemia

α-thalassemia

β-thalassemia

Hypochromic Microcytic Nl
  • Thalassemia trait: Nl or ↓
  • Thalassemia Syndromes: ↑
Nl Nl Nl to ↑ Nl Nl Nl to ↑
Disease Genetics History Symptoms Signs Hemolysis Intrinsic/Extrinsic Hb concentration MCV RDW Reticulocytosis Haptoglobin levels Hepcidin Serum iron Serum Tfr level IBC Ferritin Transferrin saturation Specific finding on blood smear

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