iron deficiency anemia(IDA) Mild thalassemia
Under group- Impaired red cell production
classification based group due to deficiency of
on underlying heme synthesis
mechanism
Inheritance disorder Not.due to iron deficiency
properties is a condition where a person
has inadequate amounts of iron
to meet body demands. It is a
decrease in the amount of red
cells in the blood caused by
having too little iron.
Iron deficiency anemia is
usually caused by a diet
insufficient in iron or from blood
loss.
Blood loss can be acute as in
hemorrhage or trauma or long
term as in heavy menstruation.
Hemolytic anemia- due to
increased destruction of
rbc due to intrinsic
abnormalitities of globin
synthesis deficiency
Yes,Heterogenous group
Due to mutation in
chromosome 11 for alpha
chain while beta is
chromosome 16
2 types of mild
thalassemia
Beta thalassemia
Not enough beta protein in the
hemoglobin results in beta
thalassemia. :
• Thalassemia minor or
thalassemia trait - only
a small lack of beta
protein, so generally
there are no health
problems except
possibly mild anemia
Alpha thalassemia
Not enough alpha protein
in the hemoglobin results
in alpha thalassemia.
• Silent carrier state -
only a small lack of
alpha protein, so
generally there are no
health problems
• Alpha thalassemia trait
or mild alpha
thalassemia - lacking
enough alpha protein to
sometimes cause mild
symptoms which are
similar to iron

causes The main causes of iron
deficiency are:
1. poor absorption of iron by
the body (Vitamin C
aides in iron absorption),
2. inadequate daily intake of
iron, pregnancy,
3. growth spurts or
4. blood loss due to heavy
period or internal
bleeding.
outcome Anemia develops slowly after the
normal stores of iron have been
depleted in the body and in the
bone marrow.
Women, in general, have smaller
stores of iron than men. Women
also lose iron more frequently
than men because of the blood
loss during menstruation.
In men and postmenopausal
women, anemia is usually due to
gastrointestinal blood loss
associated with ulcers, the use
of aspirin or nonsteroidal anti-
inflammatory medications
(NSAIDS), or colon cancer.
Gaucher Disease may also cause
anemia.
deficiency anemia
thalassemia is always
inherited, passed on from
parents to children through
their genes.
cause ineffective production of
RBCs and their destruction. As
a result, people with
thalassemia often have a
reduced number of RBCs in
the bloodstream (anemia),
which can affect the
transportation of oxygen to
body tissues. In addition,
thalassemia can cause RBCs to
be smaller than normal or drop
hemoglobin in the RBCs to
below-normal levels.
Kids who have with different
forms of thalassemia have
different kinds of health
problems. Some only have
mild anemia with little or no
effects, while others require
frequent serious medical
treatment.
 Peripheral blood film in beta
thalassemia minor.

Blood film from a dog with

chronic blood loss resulting in
iron deficiency anemia. Note
that, in addition to the
hypochromic cells (with
increased areas of central
pallor), a variety of other shape Supra vital stain in
abnormalities are present hemoglobin H disease that
(keratocytes, schistocytes)
reveals Heinz bodies (golf
ball appearance in alpha
thalassemia intermedia

Lab finding A. As iron-deficiency anemia In mild thalassemia (alpha

-RDW(red cell progresses, and the patient’s or beta), the red cells are
distribution width) serum iron drops lower and strangely all the same
size; there is virtually no
lower, each successive wave
variation. So the RDW is
of new red cells gets smaller low.
and smaller. So there are
some kind of small cells, and
some really small cells (as
you can see in the image of
iron-deficiency anemia
above). The red cell
distribution width (RDW) is
high in iron deficiency anemia
because there is a wide
variation in red cell size.
Rbc shape In beta Thalassemia,
Microcytic and hypochromic Microcytic,hypochromic
shape

Target cell also seen

Poikilocytosis-
erythrocytes showing
abnormal variation in
shape.

Aniscytosis- red blood cells

are of unequal size

Reticulocytosis-increase in
immature rbc
Normoblast-nucleated rbc
also can be seen

Alpha-thalassemia trait is
often mistaken for an iron
deficiency anemia because
RBCs will appear small
when viewed under a
microscope.

Mcv and mchc Reduction in mcv and mchc Reduction in mcv and
mchc
MCV: 80 to 100
femtoliter;; MCHC: 32  Trait -a/aa
to 36 grams/decilite
• Hemoglobin level is
within the reference
range.
• Reticulocyte count is
normal.
• Mean corpuscular
volume (MCV) ranges
between 75 and 85 fL.
• Mean corpuscular
hemoglobin (MCH) is
around 26 pg.

 Alpha1 thalassemia minor

• Hemoglobin level is
 within the reference
range.
• Reticulocyte count is
normal.
• MCV is 65-75 fL.

• MCH is around 22 pg
platelet count increase in platelet count normal

RBC Low Normal or elevated

Reason-not enough iron so Reason-unclear
bone marrow makes fewer
cells
Diagnosis • Hemoglobin
electrophoresis
Iron studies
 incubation of red blood
Increase in cells with radiolabeled
1-iron amino acid and
2-transferrin
subsequently separating
3.TIBC(Total iron-binding
capacity) α- and β-globin chains
4.transferin saturation using urea carboxymethyl
5.ferritin cellulose (CMC)
chromatography.

 Currently, genetic
testing is used to establish
the diagnosis in patients
with a suggestive family
history and/or hematologic
findings suggestive of
alpha thalassemia.6,7,8

• Recombinant DNA
technology can be
diagnostic but is still
a research tool.
• Gene mapping
• Polymerase chain
reaction (PCR)
• Restriction
endonucleases
• Anti-L globin
monoclonal
antibodies
causes of iron deficiency anemia