Clinical profile of hypochromic microcytic anemia in Chittoor district, India


  • Rajesh Kumar V. Department of Pediatrics, Apollo Medical Sciences and Research, Murakambattu, Chittoor, Andhra Pradesh, India
  • Ande Penchalaiah Department of Pediatrics, Apollo Medical Sciences and Research, Murakambattu, Chittoor, Andhra Pradesh, India



Hemoglobin, Iron deficiency anemia, Oral iron therapy, RBC Count


Background: Anemia is not a diagnosis by itself like fever but merely is an objective sign of the presence of disease. The correct diagnostic terminology for a child with anemia requires the detection of etiology, pathology, and pathogenesis of the anemia. To evaluate the role of therapeutic oral iron therapy as a diagnostic approach to hypochromic microcytic anemia.

Methods: The present study is a retrospective study conducted at the teaching hospital, Chittoor district from September 2019 to December 2019. A total number of 350 cases of anemia were studied from both inpatient and outpatient services in the age group 2 months to 12 years. Hemogram, Hb Electrophoresis, and bone marrow study as necessary based on individual cases.

Results: From the above analysis, the mean Hb% at the time of entry to study was 7.36gms%. The mean Hb% after the iron therapy was 11.8gms%. The mean increase in Hb was 4.4gms%. In this study, the average RBC count was 2.9 million cells/cumm.

Conclusions: A therapeutic trial of oral iron is an appropriate initial step in the diagnostic approach of hypochromic microcytic anemia. Costly investigations like Hb electrophoresis and bone marrow study are required only in selected cases.


Aulakh R, Sohi I, Singh T, Kakkar N. Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia. Indian J Pediatr. 2009;76:265-8.

Dallmann PR. Diagnosis of anemia and iron deficiency; Analtic and biologic variations of laboratory tests. Am J Clin Nutr. 1994;39(6)937-41.

Berman BW, Ritchey AK, Jekel JF, Schwartz AD, Guiliotis DK, Pearson HA. Hematology of β-thalassemia trait-age-related developmental aspects and intrafamilial correlations. J Pediatr. 1980 Dec 1;97(6):901-5.

Kumar GS, Rusia U. Prevalence and etiology of nutritional anemias in early childhood in an urban slum. Indian J Med Research.1998;107:69-73.

Cooley TB, Lee P. Series of cases of splenomegaly and peculiar changes in the bones. Trans Am Pediat Soc. 1925;37:29.

Cunningham TM. Hemoglobin E in Indochinese refugees. Western J Medi. 1982 Sep;137(3):186.

Dallman PR. Diagnosis of anemia and iron deficiency: analytic and biological variations of laboratory tests. Am J Clini Nutriti. 1984 Jun 1;39(6):937-41.

England JM, WARD SM, Down MC. Microcytosis, anisocytosis and the red cell indices in iron deficiency. Br J Haematol. 1976 Dec;34(4):589-97.

Fairbanks VF, Oliveros R, Brandabur JH, Willis RR, Fiester RF. Homozygous hemoglobin E mimics β‐thalassemia minor without anemia or hemolysis: Hematologic, functional, and biosynthetic studies of first north American cases. Am J Hematol. 1980 Feb;8(1):109-21.

Gomber S, Madan N. Validity of nestroft in screening and diagnosis of β-thalassemia trait. J Trop Pediatr. 1997 Dec 1;43(6):363-6.

Goodnough LT, Skikne B, Brugnara C. Erythropoietin, iron, and erythropoiesis. Blood, J Am Soc Hematol. 2000 Aug 1;96(3):823-33.

Hulthen L, Lindstedt G, Lundberg PA, Hallberg L. Effect of a mild infection on serum ferritin concentration-clinical and epidemiological implications. Eur J Clini Nutrit. 1998 May;52(5):376-9.

Johnson CS, Tegos C, Beutler E. Thalassemia Minor: Routine Erythrocyte Measurements and Differentiation from Iron Deficienc. Am J Clini Pathol. 1983 Jul 1;80(1):31-6.

Kapur D, Agarwal KN, Sharma S, Kela K, Kaur I. Iron status of children aged 9-36 months in an urban slum Integrated Child Development Services project in Delhi. Ind Pediatr. 2002 Feb;39(2):136-44.

Johnson CS, Teges C, Beutler E. thalassemia minor Routine erythrocyte measurements and differentiation from Iron deficiency. Am J Clin Pathol. 2013;80(1):31-6.

Lipschitz DA, Cook JD, Finch CA. A clinical evaluation of serum ferritin as an index of iron stores. New Engl J Medi. 1974 May 30;290(22):1213-6.

Marsh WL, Koenig HM. The laboratory evaluation of microcytic red blood cells. CRC Criti Rev Clini Lab Scie. 1982 Jan 1;16(3):195-254.

McClure S.Custer E.Bossman JD.Improved detection of early iron deficiency in non-anemic subjects. JAMA 1985;253(7)1021-3.

Mentzer W. Differentiation of iron deficiency from thalassaemia trait. Lancet. 1973;1:882.






Original Research Articles