Etiology, Investigations, and Differential Diagnosis of Microcytic Hypochromic Anemia

Introduction

Microcytic hypochromic anemia is a hematological condition characterized by small, pale red blood cells due to insufficient hemoglobin production.

Etiology

• Iron Deficiency Anemia (IDA) - Most common cause due to inadequate iron intake or absorption.
• Thalassemia - Genetic disorders affecting hemoglobin production.
• Chronic Disease Anemia - Secondary to inflammatory conditions interfering with iron metabolism.
• Sideroblastic Anemia - Abnormal iron utilization within erythroid precursors.

Laboratory Investigations

Peripheral Smear

Microscopic examination reveals microcytic and hypochromic RBCs with anisocytosis and poikilocytosis.

Iron Studies

• Serum Iron: Decreased in IDA, normal in thalassemia.
• Ferritin: Low in IDA, normal/high in anemia of chronic disease.
• Total Iron Binding Capacity (TIBC): Elevated in IDA.

Hemoglobin Electrophoresis

Useful in detecting hemoglobinopathies such as thalassemia.

Differential Diagnosis

• Distinguishing between IDA and thalassemia minor using RBC indices and iron studies.
• Excluding anemia of chronic disease through inflammatory marker assessment.

Conclusion

Accurate diagnosis of microcytic hypochromic anemia involves a detailed understanding of etiology, laboratory investigations, and differential diagnoses.