Case report: severe microcytosis associated with the anemia of chronic disease

When microcytosis is present in patients with anemia of chronic disease, the mean corpuscular volume (MCV) rarely if ever falls below 70 fL. The lowest MCV previously reported is 67 fL. We describe a patient with anemia of chronic disease with severe microcytosis and an MCV of 61 fL. After correction of the chronic disorder, complete correction of the hematologic values occurred. In patients with a low total iron binding capacity, iron therapy should not be instituted without clearly establishing the presence of iron deficiency irrespective of the degree of microcytosis.