It is likely that at early stages of iron deficiency, before the development of anemia, the impaired iron supply to the erythron produces transient bouts of iron-deficient erythropoiesis, which lead to a shift in the distribution of CHr to lower values and to the appearance of
hypochromic cells.
In functional ID, the imbalance between iron requirements of the erythroid marrow and the actual iron supply leads to a reduction of red cell hemoglobinization, which causes
hypochromic, microcytic anemia.
Both in group I and group II, 94% and 90% had
hypochromic microcytic anaemia picture in peripheral smear study.
Mutation in the mitoferrin gene has been described in a zebrafish mutant that caused profound
hypochromic anemia and erythroid maturation arrest owing to defects in mitochondrial iron uptake (38).
Hemoglobinopathies that lead to decreased production of globin chains ([alpha] or [beta]) produce a clinical syndrome characterized by anemia of variable severity with
hypochromic and microcytic red cells (41,42).
[6] The findings of normocytic
hypochromic and microcytic
hypochromic types of anaemia were predominant in our study which is consistent with other studies.
Peripheral smear findings include microcytes,
hypochromic RBC & anisopoikilocytosis.
On titration with CT-DNA, complex 1 exhibits slight
hypochromic and narrow bathochromic effects; whereas, complex 2 displays significant
hypochromic and large bathochromic effects; moreover, complex 3 shows slight hyperchromic and narrow hypsochromic effects.
Laboratory tests showed
hypochromic microcytic anemia; mild thrombocytosis; C-reactive protein level of 95 mg/L; erythrocyte sedimentation rate of 51 mm/h; PSA level of 0 ng/ml; negative results for rheumatoid factor (RF), anticitrullinated cyclic peptide antibody, and antinuclear antibody; and tumor markers levels (carcinoembryonic antigen, CA 19-9, a-fetoprotein, and |32-microglobulin) within normal ranges.
His investigations showed microcytic
hypochromic anaemia with haemoglobin 8.1 g/dl, white blood cell count 12.8 x109/l (62% polymorphs, 34% lymphocytes), platelets 546 x109/l, ESR 110 mm at the end of 1st hour, and C-reactive protein 33 mg/l.
This status may be a presentation of microcystic
hypochromic anemia, as indicated in the literature (Jagadish et al., 1998).
The anemia observed to be present among the students was of the microcytic
hypochromic type as MCV and MCHC was decreased.