Microcytic anemia

Description, Causes and Risk Factors: Microcytic anemia is one of the most common problems faced in the primary care physician's office, and for many patients is synonymous with iron deficiency anemia. Microcytic anemia refers to the presence of RBCs (red blood cells) smaller than normal size. These cells are often referred to as "erythrocytes". Microcytic anaemia can result from a defect in globin genes (i.e., hemoglobinopathies or thalassaemia), a defect in heme synthesis, a defect in iron availability, or in iron acquisition by the erythroid precursors.
  • The most common cause of microcytic anemia is iron deficiency.
  • A person who is suffering from a lot of bleeding is prone to suffer from this condition. In men, gastrointestinal (GI) bleeding is the most frequent source of iron depletion. GI bleeding may be from ulcers, inflammatory bowel conditions or even severe hemorrhoids. In woman heavy bleeding during menstruation. Other than this, those who suffer from cancer and infections can also have decreased iron and increased bleeding. These are the other causes of microcytic anemia.
  • Anemia of chronic disease is another cause of microcytic anemia. Usually this anemia is normocytic, but in a minority of cases an anemia of chronic disease can be microcytic. This type of anemia is common in patients on dialysis or with significant chronic renal insufficiency, or other patients with serious chronic medical problems.
  • Lead poisoning is the next most common and one of the most serious causes of microcytic anemia. It needs to be suspected in any young child with microcytic anemia who does not respond quickly to iron supplementation, or who lives in a home with lead pain exposure. This is mostly older homes.
  • Other hereditary conditions like hereditary spherocytosis or hereditary elliptocytosis. These are due to genetic mutations in red blood cell wall proteins that can lead to very small red blood cells that have fragile cell membranes.
  • Other causes of microcytic anemia are quite uncommon.
Symptoms: Patients with microcytic anemia experience symptoms such as:
  • Fatigue and weakness.
  • Headache.
  • Dizziness.
  • Tinnitus.
  • Fainting.
  • Shortness of breath.
  • Chest pain.
  • Palpitations.
  • Insomnia.
  • Problems in concentrating.
  • Paleness of the skin.
  • Coldness in hands and feet.
  • Constipation.
  • Rapid heartbeat.
  • Abnormal heart rhythm.
Diagnosis: When a physician sees a patient with anemia the first thing they look at is the size of the red blood cells. Microcytic denotes that the size of the red blood cells is smaller than normal red blood cells, and anemia is the name given to a reduced red blood cell hemoglobin concentration in the blood. The size of the red blood cells is measured as the mean corpuscular volume (MCV) and is normally between 80-100 microns. Microcytic anemia is when the hemoglobin concentration (Hgb) is <12 in women or <13 in men, and the MCV is <80 microns. Serum ferritin should be measured to confirm iron deficiency (except during pregnancy). This correlates with total body iron stores. However, ferritin levels can be raised if infection or inflammation is present, even if iron stores are low.
  • A ferritin level <15 mcg/L confirms iron deficiency.
  • If there is coexisting chronic inflammatory disease, the clinician should consider seeking specialist advice about other measures of iron status.
Blood film: Anisocytosis (variation in size between red blood cells) and poikilocytosis (abnormally shaped red blood cells) can be seen. In rare cases bone marrow aspiration or biopsy is needed to confirm the diagnosis. Specialty consultation with a hematologist may be needed for evaluation. Treatment: There are many potential treatments that may be used to treat microcytic anemia. In most cases, a medical professional will test the blood and will discover that there are deficiencies within the body. These deficiencies may be directly related to specific vitamins, minerals, and other types of important nutrients. As a result, many doctors will recommend supplements that will work to correct the deficiencies within the body. It is important that a sufferer avoids creating their own treatment plan. A medical professional should always take part in the development of this plan. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.  


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