Microcytic

Causes

Symptoms

Labs

Most commons

Iron
deficiency

Blood loss
Poor Diet
Malabsorptio
n

Brittle
hair/nails
Atrophic
glossitis
Angular
stomatitis
Koilonychia

Serum
ferritin,
Serum iron,
and
%
saturation
decreased

Infants/children
Males<50: PUD
Females<50:
menorrhagia/pregna
ncy

Least
commons
Malnutrion
Malabsorptio
n
Gastrctomy
Hookworms

Chronic
disease

Chronic
bacterial
infections
(osteomyeliti
s, lung
abscess,
endocarditis)
Chronic
immune( RA,
IBD)
Malignancy

Sideroblastic Alcohol
excess
B6 deficiency
Lead

Usually mild
Hb often 1011
Reticulocyte
count low
Normocytic
and
normochromi
c usually but
may be
hypochromic
and
microcytic w/
long standing
infections
(TB) or active
RA
Iron available
but unable to
synthesize it
into RBCs

TIBC, RDW,
and FEP
increased
Serum
ferritin
INCREASED

>50: Gi bleed, colon

CA
Hepcidinproduced in
liver,
decreases
iron
absorption)

Serum iron,
TIBC, and
%
saturation
decreased

Increased
serum iron,
%
saturation,
and serum
ferritin

Cytokines
(TNF, IL-1,
interferon)suppress
realase of
erythropoite
n

Alcohol

poisoning
Myelodysplas
tic syndromes
A thalassemia

Autosomal
recessive

Decreased
TIBC
Ring
sideroblast
HbHIncreased RBC
moderately
severe
Decreased H/H
hemolytic w/
RBCs sensitive Target cells
to oxidative
stress
Lower MCV

Blacks- trans
SE Asians- cis ;
HbH disease
(3del); Hb
Barts (4del)

Hb Bartsalmost no O2
to fetus=
severe
intrauterine
hypoxia, CHF,
edema,
hydrops fetalis,
death
B-thalassemia

Autosomal
recessive;
Chromosome
11

Blacks, Italians,
Greeks