What is the typical red blood cell morphology in iron deficiency anemia?

What is the typical red blood cell morphology in iron deficiency anemia?

• A. Normochromic, normocytic RBC
• B. Macrocytic RBC
• C. Hypochromic, microcytic RBC
• D. Spherocytes

Answer: (C)

Iron is needed for heme synthesis, so when iron stores are low the red cells that are produced have less hemoglobin. That makes the cells both smaller and paler—microcytic and hypochromic. This combination reflects reduced hemoglobin content per cell, which is why the typical diagnosis of iron deficiency anemia shows microcytosis (low MCV) and hypochromia (low MCHC). Early iron deficiency can be normocytic normochromic, but as deficiency progresses the microcytic, hypochromic pattern becomes the classic finding. The other patterns—normochromic normocytic, macrocytic, or spherocytes—fit different conditions (early iron deficiency, vitamin B12/folate deficiency or alcoholism, and membrane or immune-mediated hemolysis, respectively) and do not describe the standard appearance of iron deficiency anemia.

Iron is needed for heme synthesis, so when iron stores are low the red cells that are produced have less hemoglobin. That makes the cells both smaller and paler—microcytic and hypochromic. This combination reflects reduced hemoglobin content per cell, which is why the typical diagnosis of iron deficiency anemia shows microcytosis (low MCV) and hypochromia (low MCHC). Early iron deficiency can be normocytic normochromic, but as deficiency progresses the microcytic, hypochromic pattern becomes the classic finding. The other patterns—normochromic normocytic, macrocytic, or spherocytes—fit different conditions (early iron deficiency, vitamin B12/folate deficiency or alcoholism, and membrane or immune-mediated hemolysis, respectively) and do not describe the standard appearance of iron deficiency anemia.