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Forum Name: Hematology Topics

Question: Microcytic anemia, normal iron, adult


 scribblerr - Sun Oct 28, 2007 11:36 am

Hi--

I have a bit of a mystery here:

I'm a 45-year-old woman, Caucasian. No Mediterranean heritage. No internal bleeding. 7 years out from a lap RNY gastic bypass. No noticeable spleen or lymph swelling.

Was admitted following an ER visit due to anemia-- hemoglobin just under 6. Received three units of blood. Discharge papers said "Marked microcytic anemia with normal iron studies." Despite the absence of iron deficiency, I was still prescribed 65mg of ferrous sulfate 3x a day.

I have been told throughout my life that I was "a little" anemic, but it was always presented as unimportant-- "Just take a multi with a little iron in it. See you next year."

The original ER visit was due to a severe dizziness and unremitting nausea & vomiting. I was diagnosed with Meniere's 25 years ago.

I've been referred to a hematologist, but have to wait forever to see her. GP wants her to evaluate me for thalassemia. But Isn't that something they would have found lot sooner than middle age? And isn't it a super longshot that a person of Irish/Swedish/Welsh heritage would have this?

Could it really be thalassemia? What else could it be? Should I avoid exertion or exercise until I'm diagnosed? Am I a stroke/heart attack waiting to happen? (Not that I feel much like doing anything, and I have positional vertigo.)

Help! (Thank you!)
 Dr. Chan Lowe - Mon Oct 29, 2007 12:18 am

User avatar Hi Scribblerr,

This may be a thalassemia. In fact I would suspect this is fairly likely. It can be diagnosed by having a hemoglobin electrophoresis performed.

Some of these thalassemias are mild and generally don't cause any problems, others are very severe. The mild ones may not be diagnosed or may be misdiagnosed as iron deficiency.

Seeing the hematologist will be helpful.

Best wishes.
 scribblerr - Mon Oct 29, 2007 10:27 am

Thank you very much, Doctor. I thought that thalassemia was pretty much an impossible diagnosis for a middle-aged white girl! I will see the hematologist, of course. I sure wish I didn't have to wait so long. I'm worried.

I appreciate your help very, very much!

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