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Microcytosis: guidelines for family doctors

N U Abdul-Ghaffar1, M R El-Sonbaty, R Kumar

  • 1Haematology Department, Adan Hospital, Kuwait.

Tropical Doctor
|January 1, 1996
PubMed
Summary

Microcytosis affects 34.3% of patients. Non-iron deficient microcytosis, often caused by hemoglobinopathies like beta-thalassaemia minor, can be effectively diagnosed using hemoglobin electrophoresis.

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Area of Science:

  • Hematology
  • Clinical Pathology

Background:

  • Microcytosis is a common finding in complete blood count (CBC) analysis.
  • A significant portion of microcytosis cases are not attributable to iron deficiency.

Purpose of the Study:

  • To investigate the prevalence, causes, and diagnostic patterns of non-iron deficient microcytosis.
  • To identify the most effective hematological parameters for differentiating iron deficient from non-iron deficient microcytosis.

Main Methods:

  • Analysis of CBC data from 82,830 patients.
  • Detailed hematological assessment of 285 subjects with microcytosis to differentiate iron deficiency.
  • Evaluation of various non-invasive investigations including MCH, MCHC, RDW, and serum iron.
  • Hemoglobin electrophoresis was used as a key diagnostic tool.

Main Results:

  • 34.3% of patients exhibited microcytosis, with 5.5% being non-anemic.
  • Among microcytotic patients, 21.4% were classified as non-iron deficient.
  • Hemoglobinopathies, particularly beta-thalassaemia minor (60.7%), were the primary cause in 73.8% of non-iron deficient cases.
  • Hemoglobin electrophoresis demonstrated superior accuracy in distinguishing iron deficient from non-iron deficient microcytosis, showing abnormal patterns in 82% of NID subjects.

Conclusions:

  • Non-iron deficient microcytosis is a distinct clinical entity, frequently linked to hemoglobinopathies.
  • Hemoglobin electrophoresis is the most effective non-invasive investigation for diagnosing non-iron deficient microcytosis.
  • Further investigation is warranted for non-iron deficient microcytosis cases with normal electrophoresis patterns.

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