Microcytic anemia: Pathology review
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Questions
USMLE® Step 1 style questions USMLE
of complete
A 2-year-old boy is brought to the clinician by his parents due to easy fatigability and growth delay. They recently immigrated to the United States. The mother did not receive any prenatal care in her home country. The child was born at term by a normal vaginal delivery. He is at the 30th percentile for length and below the 10th percentile for weight. Temperature is 37.2°C (98.9°F), pulse is 115/min, respirations are 25/min, and blood pressure is 85/60 mmHg. Abdominal examination shows hepatosplenomegaly. Hematological tests and hemoglobin electrophoresis are obtained:
Which of the following is the most likely diagnosis?
| Laboratory value | Result |
| Hemoglobin (Hb) | 10.8 g/dL |
| Hematocrit (Hct) | 32% |
| Erythrocyte count | 5.7 million/mm3 |
| Hemoglobin A2 (HbA2) | 6.5% |
| Fetal hemoglobin (HbF) | 60% |
| Hemoglobin A (HbA1) | None |
| Hemoglobin S (HbS) | None |
Which of the following is the most likely diagnosis?
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Goldman-Cecil Medicine" Saunders (2015)
- "Letter to the Editor: Correcting iron deficiency" Australian Prescriber (2017)
- "Alpha-thalassemia" Genetics in Medicine (2011)
- "Iron deficiency anaemia" Lancet (2016)
- "Lead screening and prevalence of blood lead levels in children aged 1-2 years--Child Blood Lead Surveillance System, United States, 2002-2010 and National Health and Nutrition Examination Survey, United States, 1999-2010" MMWR Suppl. (2014)
- "Sideroblastic anemia: diagnosis and management" Hematol Oncol Clin North Am. (2014)
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