BLOOD AND BONE MARROW PICTURE IN IRON DEFICIENCY ANEMIA

BLOOD AND BONE MARROW PICTURE IN IRON DEFICIENCY ANEMIA

• Blood picture in Iron deficiency anemia

  • Shows anisocytosis, microcytosis and hypochromia

  • Red cell distribution width (RDW) – greater than 15%

  • Mean cell volume (MCV) – decreases

  • Mean corpuscular haemoglobin (MCH) – decreases

  • Mean corpuscular haemoglobin concentration (MCHC) – decreases

  • RBC count-decreases

  • Reticulocyte count –decreased as the rate of erythropoiesis is reduced.

  • Poikilocytosis-showing ellipocytes and target cells

  • WBC-Normal in morphology and number

  • Hematocrit – decreases

• Iron deficiency anemia should be suspected if there is hypochromic microcytic anemia with an elevated RDW, but no consistent shape changes in RBC.

• Bone marrow in iron deficiency anemia

  • Hyperplastic in early stages with decreased myeloid to erythroid ratio as a result of increase in erythropoiesis.

  • As disease progresses hyperplasia subsides and the profound deficiency of iron leads to slowed RBC production.

  • Late normoblasts show characteristics “Shaggy” blue cytoplasm due to  asynchrony in maturation with cytoplasmic maturation lagging behind nuclear maturation.

References

1. Elaine M. Keohane, Larry J Smith, Jeanine M. Walenga. Rodaks Haematology: Clinical Principles and Applications. Fifth edition

2. Vinay kumar, Abul K.Abbas, Jon C. Aster. Robbins and Cotran. Pathologic Basis of Disease. 9th edition

3. Shirish M.Kawthalkar. Essentials of Haematology. Second edition