Microcytic Anemia - DR GHULAM YASEEN

Microcytic Anemia

Microcytic Anemia


Microcytosis means the small size of RBCs as compared to the size of healthy RBCs, and anemia referred to the low number of red blood cells in the body. Collectively we can say that microcytic anemia is a blood deficiency disorder in which there are very few red blood cells of small size. There are certain factors that inhibit the production of hemoglobin, these factors or condition cause microcytic anemia. Hemoglobin is an essential component of your blood, that carry oxygen to every cell of the body. More often iron deficiency causes microcytic anemia because your body needs iron for the production of hemoglobin. There are many types of microcytic anemia with different causation. Your doctor starts treatment according to the underlying cause of anemia.

Sign and symptoms

At the start, you may not experience any signs and symptoms of microcytic anemia. When iron deficiency affects the tissues of the body, then signs and symptoms appear typically. Common signs and symptoms of microcytic anemia are the following:

  • Dizziness
  • Shortness of breath
  • Pale skin
  • Fatigue, weakness
  • Headache
  • Pain in body

When to visit the doctor

If you feel sign and symptoms of anemia that do not resolve for two weeks then visit your doctor as soon as possible.

Types of Microcytic Anemia

Microcytic anemia can be further divided into three types according to the presence of hemoglobin levels.

These are hypochromic, normochromic and hyperchromic anemia.

Hypochromic anemia: In this type, there is a low hemoglobin level in the RBCs, which causes hypochromic microcytic anemia. Low hemoglobin level causes decrease oxygen supply to the tissues body-due to which skin turns its healthy color to paler. Further, in hypochromic microcytic anemia, there are very few red blood cells with small size.

Hypochromic microcytic anemia has following causation

Iron deficiency anemia: most common cause of microcytic anemia is iron deficiency.

It may be due to the:

  • Low increase intake of iron in your diet
  • Certain health conditions, like celiac disease or halobacter pylori decrease the absorption of iron from the diet
  • Chronic inflammatory bowel disease or ulcers in the gastrointestinal tract that cause frequent bleeding.
  • Heavy menstruation in females
  • Pregnancy

Sideroblastic anemia: a genetic mutation or acquired condition in which the body don’t form hemoglobin. Bone marrow produces ring-shaped sideroblastic rather than normal red blood cells. In this condition, iron builds up in the red blood cells.

Thalassemia: A genetic disorder in which synthesis of faulty hemoglobin occurs due to the mutations in the hemoglobin forming genes.

 Normochromic Microcytic Anemias: in normochromic anemia red blood cells have a normal hemoglobin level but you have a low quantity of them. Under the microscope you can view that their size is normal. Conditions in which you may have normochromic anemia:

Anemia of inflammation or chronic diseases: This microcytic anemia may be seen in the patients who have

  • Infectious disease like HIV/AIDS, tuberculosis, etc
  • Inflammatory disease like rheumatoid arthritis, Crohn’s disease, or diabetes mellitus
  • Kidney disease
  • Cancers

Due to these conditions, absorption or utilization of iron decreased due to the abnormal functioning of red blood cells.

Hyperchromic  microcytic anemias:

Hyperchromic means that red blood cells have more hemoglobin than normal. This excess of hemoglobin makes red blood cells hue deep and more red in color than normal. These anemias are very rare.

Congenital spherocytic anemia: This anemia is caused by a genetic condition which is also named as congenital spherocytic anemia. It is also called hereditary spherocytosis. In this condition, the outer membrane of your red blood cells has an imperfection in shape. That cause rigid and unorganized shape. They are sent in the spleen for break down because they cannot circulate in the blood.

Other  causes of Microcytic anemia:

  • Excessive use of certain drugs
  • Lead toxicity
  • Deficiency of copper
  • Excess of zinc


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