What is 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%.
Identify which anemia is the patient experiencing, which tests should be ordered and what type of treatment should be followed.
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The patient's CBC findings suggest microcytic anemia, which is characterized by a low mean corpuscular volume (MCV) and low hemoglobin (Hgb). The most common causes of microcytic anemia are iron deficiency anemia, thalassemia, anemia of chronic disease, and sideroblastic anemia.
Given the patient's high red cell distribution width (RDW), which indicates variation in red blood cell size, the most likely diagnosis is iron deficiency anemia. In iron deficiency anemia, the body lacks enough iron to produce hemoglobin, leading to smaller and fewer red blood cells.
To confirm the diagnosis, the following tests should be ordered: serum iron, total iron-binding capacity (TIBC), ferritin, and transferrin saturation. A low serum iron, high TIBC, low ferritin, and low transferrin saturation would confirm iron deficiency anemia.
The treatment for iron deficiency anemia typically involves oral iron supplements, such as ferrous sulfate, along with dietary changes to increase iron intake. In severe cases or if oral therapy is not tolerated, intravenous iron may be administered. It's also important to identify and address the underlying cause of the iron deficiency, such as bleeding or malabsorption.
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