Q:

A patient presented with the following blood work, MCV: Decreased Serum ferritin: Decreased Total iron binding capacity: Increased Serum iron: Decreased Marrow iron: Absent. What is your diagnosis?

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A patient presented with the following blood work, MCV: Decreased Serum ferritin: Decreased Total iron binding capacity: Increased Serum iron: Decreased Marrow iron: Absent. What is your diagnosis?


  1. Thalassemia trait
  2. Hypoparathyroidism
  3. Hereditary sideroblastic anemia
  4. Protein energy malnutrition
  5. Chronic renal failure
  6. Anemia of chronic disease
  7. Acute blood loss
  8. IDA

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The key is H. Iron deficiency Anemia (IDA). [S/S pallor, koilonychia,angular cheilitis, atrophic glossitis, IN marked Anemia ( Cardiac enlargemnet,Flow Murmurs,ankle oedema and heart failure) Investigation: FBC : shows microcytic hypochromic anemia, Serum ferrtitin Level reduced, normal 12-15 mcg/L, ( serum ferritin is falsely raised during infections), Anisocytosis and poikilocytosis. Total iron binding capacity is increased. Treatment: Iron supplememtation with B12 and folic acid]. 

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