A 45-year-old woman presents to the clinic complaining of generalized fatigue and weakness for the past 3 months. She reports having heavy menstrual periods lasting 7 to 8 days each month. Vital signs are within normal limits. Physical examination reveals pale conjunctivae.
Laboratory results are as follows:
| Test | Result | Reference Range |
|---|---|---|
| Hemoglobin | 9.2 g/dL | 12.0-15.5 g/dL |
| Mean corpuscular volume (MCV) | 72 fL | 80-100 fL |
| Serum iron | 25 µg/dL | 60-170 µg/dL |
| Total iron-binding capacity (TIBC) | 480 µg/dL | 240-450 µg/dL |
| Serum ferritin | 8 ng/mL | 12-150 ng/mL |
Which of the following is the most likely diagnosis based on these laboratory findings?
- Iron deficiency anemiaCevap
- BAnemia of chronic disease
- CBeta-thalassemia trait
- DSideroblastic anemia
- EFolate deficiency
Cevap
Iron deficiency anemia
The correct answer is iron deficiency anemia. The laboratory results show a microcytic anemia (MCV < 80 fL) accompanied by a classic iron deficiency profile. In iron deficiency, total body iron stores are depleted, leading to a characteristically low serum ferritin (the most sensitive and specific marker). In response to low iron stores, the liver increases the production of transferrin, which is reflected as an elevated total iron-binding capacity (TIBC). The combination of low serum iron, high TIBC, and low ferritin in a menstruating woman with fatigue definitively confirms this diagnosis.
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Anahtar Kavram
Interpreting iron studies to diagnose the specific cause of a microcytic anemia.