Hypochromic Microcytic Anemia

Running head: HYPOCHROMIC MICROCYTIC ANEMIA
\
HYPOCHROMIC MICROCYTIC ANEMIA
Name of the Student
Name of University
Author’s note

HYPOCHROMIC MICROCYTIC ANEMIA
Hypochromic microcytic anemia
Introduction
Anemia can be referee to as the random reduction of the red blood cells below the
standard level. Anemia is condition that is common within the human population. Iron is the
main component of the hemoglobin and is the main carrier of oxygen. The decreased iron
reserves of the body affects the production of the hemoglobin that ultimately hinders the
transport of oxygen to the different organ systems of the body. The oxygen carrying capacity of
the blood is reduced due to anemia.
Causes
Microcytic, hypochromic anemia is the type of anemia where the circulating RBCs are
smaller than the usual size of the RBCs (microcytic) and have decreased red color
(hypochromic). This anemia is caused by the decreased iron content in the body (Chaudhry and
Kasarla 2018). Decreased iron reserves in the body can be due to several factors like decreased
content of iron in the diet, poor absorption of the iron from the gut, acute and chronic blood loss,
increased demand of iron in body in certain situations like pregnancy, or after a major surgery
where a lot of blood has been lost.
Pathogenesis
According to DeLoughery (2014), the normal diet of an adult requires 1 mg to 2 mg per
day of iron. The normal western diet consists of approximately 10 mg to 20 mg of iron. Iron

HYPOCHROMIC MICROCYTIC ANEMIA
from the animal sources have a bioavailability of about 10- 20 % in comparison to the non heme
iron that have less bioavailability of about 1% to 5%. Low non heme iron is low in
bioavailability due to the interaction with the tannins, phosphates and the other food constituents.
Normally an average male requires 6 gram of iron, whereas a female contain 2.5 gram of iron
(Chaudhry and Kasarla 2018). It can only be maintained by a healthy diet. The iron ingested in
the diet is freed from the food by the help of the HCL and the ascorbic acid (vitamin C) restricts
the precipitation of the ferric. The absorption of the iron takes place from the duodenum and the
upper parts of the jejunum by the help of an iron transporter called ferroportin. The iron is
usually stored in the form of ferritin that is a ubiquitous protein found in large amount in the
spleen, liver, bone marrow and the skeletal muscles (DeLoughery 2014). In the liver, it is stored
in the parenchymal cells while in the other tissues, the iron is stored in the
macrophages .Hepcidin is a protein that regulates the amount of the iron absorbed form the gut
(Chaudhry and Kasarla 2018).
Hemoglobin is a globular protein, that is the main component of the RBC and it is
manufactured in the bone marrow by the help of the erythroid progenitor cells. Hemoglobin has
four globin chains. Two of the chains are the alpha globin chains and the other two are the beta
globin chains and these four chains are attached to the porphyrin chains (DeLoughery 2014).
Reduced iron reserves in the body reduces the production of the hemoglobin chains and
the concentration begins to become less in the newly formed RBCs and since the red color of the
RBCs is due to the hemoglobin content, the color of the newly formed blood shows a fade color
and thus the name hypochromic.

HYPOCHROMIC MICROCYTIC ANEMIA
Hypocromic anemia have also been found to be occurring due to several clinical
conditions like pathology of the small intestine like chronic diarrhea or spruce, gastrectomey
and deficiency of vitamin C in the diet (Naigamwalla, Webb and Giger 2012).
Differential diagnosis
Some of the differential diagnosis of hypochromic anemia is anemia of chronic diseases,
thalassemia, X- linked sideroblastic anemia and lead poisoning (Urrechaga et al. 2015). Again
low reserve in the iron is caused due to partial gastrectomy, malabsorption syndromes and other
methods of blood loss due to gastrointestinal disease, peptic ulcer disease, drugs, infection,
inflammation, malignancy, menstruation or self-inflicted blood loss and surgery (Urrechaga et al.
2015).
One of the important differential diagnoses of anemia is thalassemia that is often
confused with microcytic anemia on the basis of CBC and the peripheral blood smear findings.
In order to distinguish thalassemia from microcytic anemia, several indices have to be used.
Thalessemia is mainly caused due to the impaired synthesis of the globin chains causing a
quantitative decrease in the hemoglobin content within the cell. It has been found that
thalassemia minor/ trait might give rise to microcytic hypochromic anemia symptoms.
X-linked sideroblastic anemia is a group of disorders that can be characterized by the
disruptive utilization of the iron resulting in the diminished heme synthesis (Bottomley and
Fleming 2014). The diminished heme synthesis resulting due to the impaired utilization of the
iron hence results in a continued stimulus for the absorption of iron , despite of an adequate or
the increased level of intracellular iron. Excessive iron is being deposited in the mitochondria