Quick Review Cards for Medical Laboratory Science

Microcytic, Hypochromic Anemias Hematology Review 311

ANEMIA ETIOLOGY BLOOD SMEAR OTHER

Iron deficiency

anemia (IDA)

Sideroblastic anemia

b–thalassemia major

b–thalassemia minor

Anemia of chronic

inflammation*

Insufficient iron for hgb

synthesis.

Enzymatic defect in heme

synthesis.

↓b-chain production.

↓b-chain production.

Acute phase reactants (e.g.,

hepcidin) affect iron absorp-

tion & release. Iron in bone

marrow macrophages is not

released to developing RBCs.

Aniso, poik, hypochromic

microcytes

Dual population of RBCs

(normocytic & microcytic),

Pappenheimer bodies,

basophilic stippling

Marked aniso & poik,

hypochromic microcytes,

target cells, ovalocytes,

nRBCs, basophilic stippling

Aniso, poik, hypochromic

microcytes, target cells,

basophilic stippling

60%–70% of cases have

normocytic normochromic

RBCs; 30%–40% microcytic

hypochromic

Most common anemia.

RBC indices usually normal.

Ringed sideroblasts in marrow.

Homozygous. Little or no Hgb A,

95%–98% F, 2%–5% A 2.

Severe anemia. MCV <67 fL.

Heterozygous. >90%–95% Hgb A,

3.5%–7% A 2 , 2%–5% F.

Mild anemia.

Associated with chronic infections &

inflammation, malignancies, autoim-

mune diseases. 2nd most common

anemia after IDA. Most common

anemia in hospitalized pts.

*Formerly known as anemia of chronic disease. More often normocytic normochromic but included here because must be considered in differential Dx of microcytic anemia.