Diagnosis of Iron Deficiency

Diagnosis of Iron Deficiency

What is the most likely diagnosis for a patient with the following CBC findings? WBC: 8.8 × 103/µl; RBC: 3.01 × 103/µl; Hgb: 10.3 g/dL; Hct: 32.2%; MCV: 74 fL; MCHC: 28.3 g/dL; Plt: 400 × 103/µl; RDW: 18.4%; Reticulocytes: 2.1%.

Identify which anemia is the patient experiencing, which tests should be ordered and what type of treatment should be followed.

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Diagnosis of Iron Deficiency

Likely Diagnosis:

Based on the provided CBC findings, the most likely diagnosis is iron deficiency anemia (IDA). Here’s the reasoning behind this:

• Low RBC count (3.01 × 10³/µl), hemoglobin (Hgb 10.3 g/dL), and hematocrit (Hct 32.2%): These values suggest that the patient is anemic.
• Low MCV (74 fL): This indicates microcytic anemia, which is commonly seen in iron deficiency anemia, where red blood cells are smaller than usual.
• Low MCHC (28.3 g/dL): This suggests hypochromia, where the red blood cells have less hemoglobin content, often seen in iron deficiency anemia.
• High RDW (18.4%): A high RDW indicates variation in red blood cell size (anisocytosis), which is characteristic of iron deficiency anemia as the body attempts to produce new red blood cells in response to low iron.
• Elevated platelet count (Plt 400 × 10³/µl): Thrombocytosis (elevated platelets) can be a secondary finding in iron deficiency anemia.
• Reticulocyte count (2.1%): The elevated reticulocyte percentage suggests that the bone marrow is responding to the anemia by producing more red blood cells, which can occur in early or compensated stages of iron deficiency.

Type of Anemia:

The patient is most likely experiencing microcytic hypochromic anemia due to iron deficiency.

Tests to Order:

To confirm the diagnosis of iron deficiency anemia and assess its underlying cause, the following tests should be ordered:

1. Serum Ferritin: A low ferritin level confirms iron deficiency, as ferritin is a marker of stored iron.
2. Serum Iron: Measures the amount of iron in the blood, which is typically low in iron deficiency anemia.
3. Total Iron-Binding Capacity (TIBC): Elevated in iron deficiency anemia because the body attempts to bind more iron to transport proteins.
4. Transferrin Saturation: This can be calculated from serum iron and TIBC. It is typically low in