The most likely diagnosis for a patient with the following CBC findings? WBC: 8.8 × 103/µl; RBC: 3.01 × 103/µl; Hgb: 10.3 g/dL; Hct: 32.2%; MCV: 74 fL; MCHC: 28.3 g/dL; Plt: 400 × 103/µl; RDW: 18.4%; Reticulocytes: 2.1%.

Sample Solution

The most likely diagnosis is iron deficiency anemia. Several findings point to this: low hemoglobin (Hgb), hematocrit (Hct), and mean corpuscular volume (MCV) indicate anemia and microcytic red blood cells. The low mean corpuscular hemoglobin concentration (MCHC) further supports iron deficiency. While the platelet count is slightly elevated, this can be a reactive thrombocytosis often seen in iron deficiency. The elevated red cell distribution width (RDW) suggests variation in red blood cell size, also common in iron deficiency. The reticulocyte count is slightly elevated, suggesting the bone marrow is trying to compensate for the anemia.

To confirm iron deficiency anemia, the following tests should be ordered:

• Serum ferritin: This is the most sensitive test for iron deficiency, reflecting iron stores.
• Serum iron and total iron-binding capacity (TIBC): These help assess iron availability and binding capacity. Low serum iron and high TIBC are typical in iron deficiency.

Full Answer Section

Treatment for iron deficiency anemia involves:

• Oral iron supplementation: Ferrous sulfate is a common and effective option. It's important to take it on an empty stomach (if tolerated) for better absorption and to address any underlying cause of iron loss.
• Dietary changes: Increasing iron intake through foods like red meat, leafy greens, and fortified cereals can support treatment.
• Addressing the underlying cause: Identifying and treating the source of iron loss, such as heavy menstrual bleeding or gastrointestinal bleeding, is crucial for long-term management. In severe cases, blood transfusion might be necessary.