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.
250 words
The patient’s CBC findings suggest microcytic anemia, likely iron deficiency anemia (IDA), given the low mean corpuscular volume (MCV: 74 fL), low mean corpuscular hemoglobin concentration (MCHC: 28.3 g/dL), and elevated red cell distribution width (RDW: 18.4%). The reticulocyte count is slightly elevated (2.1%), indicating some bone marrow response, but it is not enough to compensate for anemia.
Additional Tests to Confirm Diagnosis
To differentiate IDA from other microcytic anemias (e.g., thalassemia, anemia of chronic disease, lead poisoning), the following tests should be ordered:
- Serum ferritin (low in IDA)
- Serum iron, total iron-binding capacity (TIBC), and transferrin saturation (low iron, high TIBC, and low transferrin saturation in IDA)
- Peripheral blood smear (may show hypochromic, microcytic RBCs)
- Fecal occult blood test (FOBT) (if GI blood loss is suspected)
- Hemoglobin electrophoresis (if thalassemia is a concern)
Treatment Approach
- Oral iron supplementation: Ferrous sulfate 325 mg PO daily or every other day, taken with vitamin C to enhance absorption.
- Dietary modifications: Increase intake of iron-rich foods (red meat, leafy greens, fortified cereals).
- Treat underlying cause: If due to chronic blood loss (e.g., gastrointestinal bleeding), address the source.
- Monitoring: Reassess CBC and ferritin levels in 4–6 weeks to evaluate response to therapy.
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.
250 words