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A 1 9-year-old female patien t of Greek heritage presen ts for evaluation of anemia. She is 7 mon ths pregnan t. Complete blood count (CBC) shows leukocyte count of S , LJOO/ ,uL. hemoglobin 8.8 g/dl with MCV 62 .7 FL. and platelet count 251 ,000/ ,ul. The peripheral smear is shown below.
What would support a diagnosis of beta thalassemia trait rather than simple iron deficiency?
- Elevated RBC count
- Elevated mean corpuscular hemoglobin concentration
- Elevated red cell distribution width (RDW)
- Decreased RBC count
Medicine
A. A consistent finding in carriers ofbeta thalassemia is microcytic anemia with an elevated RBC count. The blood smear shows microcytic hypochromic red cells and target cells. Iron-deficiency anemia is associated with an increased RDW and decreased RBC counts (Am l Public Health. 1988 November;78(1 1 ): 1476- 1477).
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