Based on the CBC and iron studies, what is the presumptive diagnosis?

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Multiple Choice

Based on the CBC and iron studies, what is the presumptive diagnosis?

Interpreting CBC alongside iron studies lets us distinguish microcytic anemias by how iron is handled in the body. In iron deficiency anemia, stores are depleted, so ferritin falls, serum iron falls, transferrin saturation falls, and the transferrin (or total iron-binding capacity) rises as the body tries to grab more iron. The red cells become smaller and paler (low MCV and low MCHC), and the RDW often increases because new cells issued during ongoing iron shortage vary more in size. This pattern is distinct from anemia of chronic inflammation, where ferritin is normal or high and TIBC is low despite low serum iron; from sideroblastic anemia, which shows high iron and high ferritin with low TIBC; and from thalassemia, where iron studies are typically normal or not clearly deranged and RBC indices show a characteristic profile with often high RBC count. Given the CBC and iron studies in this case, the hallmark combination points to depleted iron stores and iron-deficient erythropoiesis, making iron deficiency anemia the presumptive diagnosis.

Interpreting CBC alongside iron studies lets us distinguish microcytic anemias by how iron is handled in the body. In iron deficiency anemia, stores are depleted, so ferritin falls, serum iron falls, transferrin saturation falls, and the transferrin (or total iron-binding capacity) rises as the body tries to grab more iron. The red cells become smaller and paler (low MCV and low MCHC), and the RDW often increases because new cells issued during ongoing iron shortage vary more in size. This pattern is distinct from anemia of chronic inflammation, where ferritin is normal or high and TIBC is low despite low serum iron; from sideroblastic anemia, which shows high iron and high ferritin with low TIBC; and from thalassemia, where iron studies are typically normal or not clearly deranged and RBC indices show a characteristic profile with often high RBC count. Given the CBC and iron studies in this case, the hallmark combination points to depleted iron stores and iron-deficient erythropoiesis, making iron deficiency anemia the presumptive diagnosis.

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