Fast Five Quiz: How Familiar Are You With Iron Deficiency Anemia?

Emmanuel C. Besa, MD; Derek B. Laskar, MD

Disclosures

June 17, 2020

Examination of the peripheral blood smear is an important part of the workup of patients with anemia. Unlike in the thalassemias, target cells are usually not present, and anisocytosis and poikilocytosis are not marked in iron-deficiency anemia. This condition lacks the intraerythrocytic crystals seen in hemoglobin C disorders.

The erythrocyte morphology reveals microcytosis and hypochromia. The microcytosis is apparent in the smear long before the mean corpuscular volume is decreased after an event producing iron deficiency. Platelets may be increased in response to elevated erythropoietin levels.

While a low serum ferritin is essentially diagnostic of iron deficiency, a normal serum ferritin can be seen in patients who are deficient in iron and have comorbid diseases, such as hepatitis or anemia of chronic disorders. Such findings are useful in distinguishing iron-deficiency anemia from other microcytic anemias.

Learn more about the workup of iron deficiency.

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