Hypochromic Microcytic Anemia | Figure 1

Hypochromic Microcytic Anemia

A 43-year-old woman who presents with a history of generalized pallor of long evolution, does not know the exact time. Accompanied by weakness and dizziness.

Blood Pressure: 110/80 mmHg
Heart Rate: 89 bpm
Respiratory Rate: 21 rpm
SpO2: 98%

Physical examination revealed paleness in mucous membranes and nail beds. Visceromegaly is not evident on abdominal palpation.

Complete Blood Count:

With that CBC results I decided to order reticulocytes, serum iron levels, and ferritin (which she could not afford).

Having these results, iron deficiency anemia is ruled out, and thalassemia would remain as a differential diagnosis. What complementary tests can be requested from the patient to confirm or rule out the diagnosis?

Updates to this case:

Cochrane Review

Why do we need iron in our diet?

Iron is an essential mineral found in every cell of the body. It is needed to make haemoglobin, the oxygen‐carrying protein in the blood. Iron molecules in haemoglobin bind to oxygen and carry it from the lungs to all the cells and tissues in the body. Low levels of haemoglobin means the body does not get enough oxygen.

Anaemia develops when haemoglobin levels in the blood fall too low. Symptoms of anaemia include: tiredness and lack of energy, getting out of breath quickly, pale skin and a greater susceptibility to infections.

Low haemoglobin levels can be caused by blood loss, pregnancy, or not eating enough foods containing iron (iron‐deficiency anaemia). Iron‐deficiency anaemia may be treated by taking iron tablets or eating foods rich in iron.

Fortified Foods

Adding micronutrients (vitamins and minerals) to foods, whether those micronutrients were originally present or not, is called fortification. Fortifying foods is one way to improve nutrition in a population.

People living in low‐income countries may not have enough iron in their diet and may be at risk of anaemia. Adding iron and other nutrients to foods routinely eaten in large quantities, such as flour, is thought to help prevent iron‐deficiency anaemia.

Study Findings

We found 10 studies in 3319 people (aged 2 years and older). The studies lasted from 3 months to 24 months, and took place in Bangladesh, Brazil, India, Kuwait, the Philippines, Sri Lanka, and South Africa.

The studies looked at the effects of:

The wheat flours used in the studies contained different amounts of iron: from under 40 mg/kg to over 60 mg/kg.

Results

Compared with flour without added iron (but with other minerals and vitamins), flour containing added iron (with or without other minerals and vitamins) may reduce anaemia by 27%.

Key Messages: