CP109 follow ups for microytic anemia

Ajouté : 2026-05-28

[00:00:00]Then I want to talk about some really important tests to do follow-ups when if you ever see a I don't know what looks like iron deficiency anemia or basically when you see a microcytic hypochromic anemia, which is low hemoglobin, low hematocrit, low RBC, low MCV, low MCH, low MCHC. If you see that pattern, it may be iron deficiency, but it may not. So, the three follow-up tests you really want to consider is number one, you want to look at a reticulocyte count.

[00:00:25]If the reticulocyte count is elevated, that suggests you have internal bleeding and you have to look for those causes for why they might have this anemia pattern.

[00:00:32]You also want to run a soluble transferrin receptor test. If that is normal, that means that their anemia is really secondary to inflammation. They actually have an iron deficiency and their soluble transferrin receptor marker would be elevated.

[00:00:48]And the third consideration is you may want to order a peripheral smear. If the peripheral smear shows they have reticulo- they have sideroblastic cells and they have a sideroblastic anemia, it's really more of a B6 deficiency anemia. Now, if the soluble [clears throat] transferrin receptor is elevated, they don't have a high reticulocyte count, and this peripheral smear is all normal, then it really is an iron deficiency mechanism.

[00:01:10]Then you got to figure out why they have iron deficiency. Is it uh uh malabsorption issues from their medication like proton pump inhibitors?

[00:01:18]Do they have celiac disease? Do they have what kind of villous atrophy or some kind of intestinal destruction? Are they just not getting enough in their diet? Do they have some kind of tissue growth demand increasing iron demand like a uterine fibroid or a tumor? Um But to be very frank, it's it's very rare that a person has a I don't know what you know as iron deficiency anemia simply because they're just not eating enough iron. There's typically mechanisms involved that are causing it.

[00:01:46]Number one really being associated with lack of hydrochloric acid, hypochlorhydria, H. pylori infections, uh ulcers, and things of that nature.

[00:01:56]That's all.