Microcytic anaemia

Question 1

Causes?

Answer 1

• iron-deficiency anaemia
• thalassaemia*
• congenital sideroblastic anaemia
• anaemia of chronic disease (more commonly a normocytic, normochromic picture)
• lead poisoning

Question 2

A question sometimes seen in exams gives a history of a normal haemoglobin level associated with a microcytosis?

Answer 2

In patients not at risk of thalassaemia, this should raise the possibility of polycythaemia rubra vera which may cause an iron-deficiency secondary to bleeding.