Types of microcytic, hypochromic anemia... Iron deficiency will have a high RDW with low ferritin... Thalassemia's will have normal RDW and elevated ferritin (due to RBC turnover)... after thalassemia is suspected, electrophoresis should be done to distinguish alpha (normal) from beta (elevated HbA2 levels)
Target cells. Red cells with thin membrane, peripheral rim of hemo- globin (Hb), and dark, central, Hb-containing area. They are frequently seen in Hb C disease, in hypochromic anemia, and in liver disease
Hereditary pyropoikilocytosis - RBC membrane disorder - This peripheral blood smear is from a 22-year-old female who presented to the emergency department with right upper quadrant pain. The CBC was remarkable for a microcytic, hypochromic anemia (hemoglobin = 9.6 g/dL; MCV = 68.2 fL and MCH = 22.1 pg), normal WBC count, and a platelet count of 153K. Examination of the peripheral blood film showed marked anisocytosis with numerous rod-shaped elliptocytes and bizarre red cell forms.
Sideroblastic anemia. Presence of anemia + ringed sideroblasts. Hypochromic, BIMODAL RBC population. +/- Pappenheimer bodies (iron). Increased iron stores in BM. All iron studies are elevated (but distinguish from hemochromocytosis because SA has low hgb and low MCV). CAUSES: ACQUIRED = RARS, meds, alcohol, Pearson syndrome and low copper. VAST MAJORITY HAVE CLONAL DEFECT. MACROCYTIC. >15% RS. INHERITED = rare, X-linked. ALAS2 gene. MICROCYTIC. Can try giving a ton of B6.