A 33 year old patient presents with fatigue to her family physician’s office. Her blood work is shown below. What is the differential for her blood findings and why?
|Hematocrit||0.249||(0.345 – 0.450)/L|
What is your differential diagnosis for a microcytic anemia?
- Anemia of chronic disease
- Iron deficiency anemia
- Lead poisoning
- Sideroblastic anemia
What ferritin value increases the likelihood of iron deficiency?
A ferritin of less than 18 ug/L has a likelihood ration of over 41 for iron deficiency anemia.
What is the gold standard for investigation?
A bone marrow biopsy.
Guyatt et al. Diagnosis of iron-deficiency anemia in the elderly. (1990) AJM 88:205-209