A young female has the following lab values: Hemoglobin=9.8 gm%, MCV=70, serum iron= 50ug/dl, serum ferritin =100ng/dl, the diagnosis is?
Thalassemia intermedia
Chronic iron deficiency anaemia
Megaloblastic anaemia
Anaemia of chronic infection
Interpretation of parameters provided in question: MCV Decreased (N 80-100 fl) Serum iron Lower range of normal (N 50-150 ug/dl) Serum ferritin Normal (N 50-300 ng/ml) Hemoglobin Decreased (N 14-16 g/dl) Diagnosis of Thalassemia intermedia is based on H.P.L.C / Hemoglobin electrophoresis. Serum iron level is increased in Thalassemia because of increased intestinal absorption of iron and ongoing hemolysis. Hence choice A is ruled out. Due to low iron but normal ferritin iron deficiency is ruled out as serum ferritin is first to reduce in iron deficiency anemia. Choice B is ruled out. Since MCV is low it is a microcytic anemia. Choice C is ruled out. This is a likely case of anemia of chronic disease in which serum ferritin is normal to increased while the serum iron level is usually on the lower side.
Thalassemia