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Case Study (4)- Iron deficiency anemia

Case Study (4)- Iron deficiency anemia


70-year-old female. Symptoms of dyspnea on exertion, easy fatigability, and lassitude for the past 2 to 3 months. Denied hemoptysis, GI, or vaginal bleeding. The claimed diet was good, but appetite varied.

Physical Examination:

- Pallor.
- No other significant physical findings were noted.
- Occult blood was negative.

Laboratory Investigations:

1. CBC: (with microscopic differential)

RBC 3.71 x 1012/L

HGB 5.9 g/dL

HCT 20.9 %

MCV 56.2 fL

MCH 15.9 pg

MCHC 28.3 g/dL

RDW 20.2

WBC 5.9 x 109/L

N 82 %

L 13 %

M 1 %

E 4 %

B 0 %

PLT 383 x 109/L

Morphologic Alterations

Results of the blood smear exam were:
RBC morphology:
2+ hypochromasia
3+ microcytosis
2+ anisocytosis
2+ elliptocytes and target cells
occasional teardrops and fragments

WBC morphology: Within normal limits

PLT morphology: Within normal limits

2. Iron studies were performed, and the results were:

serum ferritin <10 ng/mL (RI 12-86)

serum iron 24 µg/dL (RI 65-175)

TIBC 729 µg/dL (RI 250-410)

saturation 3 % (RI 20-55)


Iron deficiency anemia

Clinical Course

Diagnostic procedures included upper GI endoscopy, colonoscopy, and small bowel biopsy. All were negative.

The patient received packed RBC transfusions and was started on iron therapy.

She refused any further laboratory testing or other procedures and was discharged at her request. She was lost to follow-up.

The etiology of her iron deficiency anemia could not be determined, but it was most likely nutritional.