Fast Five Quiz: Signs and Symptoms of Iron Deficiency Anemia

James L. Harper, MD


October 22, 2021

Iron deficiency anemia is easily diagnosed on the basis of decreased levels of serum ferritin and transferrin saturation, as well as elevated total iron binding capacity.

Obtaining a complete blood cell count will determine the severity of the anemia. In chronic iron deficiency anemia, the cellular indices show microcytic and hypochromic erythropoiesis: that is, both the mean corpuscular volume and the mean corpuscular hemoglobin concentration are below the normal range. Reference range values for mean corpuscular volume and mean corpuscular hemoglobin concentration are 83- and 32-36 g/dL, respectively. The platelet count is often elevated (> 450,000 cells/µL). In addition, the white blood cell count is usually within the reference range (4500-11,000 cells/µL), but it may be elevated.

Spherocytes are marked in the setting of hemolytic anemias, particularly hereditary spherocytosis and autoimmune hemolytic anemia.

Nonspecific abnormalities of epithelial tissues are reported in iron deficiency, such as gastric atrophy and clubbing of the small intestinal villi. Although these features point to iron deficiency being a pantropic disorder, they offer little diagnostic value.

In iron deficiency anemia, unlike thalassemia, target cells usually are not present. The intraerythrocytic crystals observed in hemoglobin C disorders are not seen in iron deficiency anemia.

Learn more about the workup of iron deficiency anemia.


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