A 9-month-old boy presented to you with complaints of progressive lethargy, irritability & pallor since 6 months of age. Examination revealed severe pallor. Investigation showed Hb —4.5 mg%; MCV —58 ; MCH - 20.
Peripheral blood smear shows target cells and normoblasts, with normal osmotic fragility. Xray skull shows expansion of erythroid marrow. Most probable diagnosis of this patient is
A. Iron deficiency anemia
B. Chronic Siderosis
C. Hemoglobin D disease
D. Hereditary spherocytosis
Ans. A.
Iron deficiency anemia.
In iron deficiency anemia:
• RBC’s becomes smaller microcytosis. than normal and their Hb content is decreased hypochromia. .
• Bone marrow is hypercellular, with erythroid hyperplasia.
• Normoblasts may have scanty, fragmented cytoplasm with poor hemoglobination. Osmotic fragility will be normal.
• Peripheral blood film will show poikilocytosis, increased RBC distribution, nucleated RBC, normal WBC and sometimes thrombocytosis.
In ALL: There will be leukocytosis with leukoblasts lymphoblasts. .
Hb D disease: It will behave as thalassemia. It is generally asymptomatic or there is only mild anemia and persons lead a normal life.
Hereditary spherocytosis: It will have normal MCV, RBC’s shows spherocytes, reticulocytes osmotic fragility is exaggerated.
In iron deficiency anemia:
• RBC’s becomes smaller microcytosis. than normal and their Hb content is decreased hypochromia. .
• Bone marrow is hypercellular, with erythroid hyperplasia.
• Normoblasts may have scanty, fragmented cytoplasm with poor hemoglobination. Osmotic fragility will be normal.
• Peripheral blood film will show poikilocytosis, increased RBC distribution, nucleated RBC, normal WBC and sometimes thrombocytosis.
In ALL: There will be leukocytosis with leukoblasts lymphoblasts. .
Hb D disease: It will behave as thalassemia. It is generally asymptomatic or there is only mild anemia and persons lead a normal life.
Hereditary spherocytosis: It will have normal MCV, RBC’s shows spherocytes, reticulocytes osmotic fragility is exaggerated.
