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- W1985133066 abstract "22-year-old woman who had no notable previous medical history reported increasing fatigue during the past few months. Her mother noticed that she looked pale and suggested she visit her family physician. Her family and personal histories were noncontributory. Findings on physi cal examination were remarkable only for pallor. In particu lar, she had no hepatosplenomegaly or lymphadenopathy. Initial laboratory tests yielded the following results (ref erence ranges shown parenthetically): hemoglobin, 8.3 g/ dL (12.0-15.5 g/dL); hematocrit, 26.2% (34.9%-44.5%); mean corpuscular volume (MCV), 65.3 fL (81.6-98.3 fL); red blood cell (RBC) count, 4.01 X 1012/L (3.90-5.03 X 10 12/ L); and reticulocyte count, 1.17% (0.60%-1.83%). Leuko cyte and platelet counts were within normal limits. The peripheral blood smear is shown in Figure 1. 1. Which one ofthe following is the least likely diagnosis in this patient? a. Iron deficiency anemia (IDA) b. Thalassemia c. Anemia ofchronic disease d. Sideroblastic anemia e. Hereditary spherocytosis The peripheral blood smear showed hypochromic mi crocytic anemia with moderate anisocytosis and poikilo cytosis. The differential diagnosis of microcytic anemia includes thalassemia, iron deficiency, chronic disease, and sideroblastic anemia. IDA is the most common cause of microcytic anemia. In adults, dietary deficiency is rare, and bleeding must always be excluded. Red cell distribution width (RDW), an index of anisocytosis, is usually in creased in patients with iron deficiency. However, this is a nonspecific finding. Thalassemia consists of a hetero geneous group of disorders with defects in the synthesis of" @default.
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- W1985133066 date "2000-08-01" @default.
- W1985133066 modified "2023-09-26" @default.
- W1985133066 title "22-Year-Old Woman With Severe Microcytic Anemia" @default.
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- W1985133066 doi "https://doi.org/10.4065/75.8.861" @default.
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