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
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).
 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.