Abstract

FELISA AIXALA, Mónica Teresita. Microcytic and hypochromic anemia: iron deficiency anemia versus b thalassemia trait . Acta bioquím. clín. latinoam. [online]. 2017, vol.51, n.3, pp.291-305. ISSN 0325-2957.

Microcytic hypochromic anemia (m-H) presents MCV<80 fL and MCH<27 pg. m-H can result from iron availability, defects in globin or HEMO synthesis. The most frequent m-H is iron deficiency anemia (IDA), followed by thalassemias and anemia chronic disease. Rare m-H are a consequence of HEME defects or iron metabolism genetic defects. The aim of this study is to review the differential diagnosis between IDA and b thalassemia trait (b thal trait), the most frequent in our environment. Results of laboratory tests are analysed. Erythrocytes, hemoglobin, reticulocytes, iron, ferritin, transferrin saturation, HbA2 and percentage of morphologic changes are lower in IDA compared with b Thal trait. MCV, MCH, RDW, microcytic index, transferrin and soluble transferrin receptor are higher in IDA compared with b Thal trait. Oxidative stress is increased in the two forms of microcytoses. Degree iron deficiency in IDA and b Thal trait mutation must be considered in the analysis of the parameters. A flowchart is proposed to evaluate m-H stemming from serum iron value. After excluding the most frequent causes of microcytic anemia, a thalassemia trait must be considered.

Keywords : Microcytosis; Iron deficiency; Mean corpuscular volume; blood cell distribution width; Hypochromia; Thalassemia; Microcytosis discriminant indices; Transferrin receptor; Hemoglobin electrophoresis; Oxidative stress.