188) A 24 year old woman is evaluated for a history of chronic anemia. Her history is significant for anemia for the past 7 years. She has been treated with oral iron supplements in the past with out any response. She denies any gastrointestinal bleeding. Her menstrual cycle is 3 days in duration and her menses have been scant for the past 5 years. There is no family history of anemia or bleeding disorder or cancer. Physical examination is unremarkable. Laboratory investigations reveal :
Hemoglobin : 10.6gm%
MCV: 68fl ( normal 80 to 100)
WBC : 8.8K/μl
Platelets: 230k/μl
Red Cell Distribution Width : 12.8% ( 10.2 to 14.5%)
Reticulocyte count : 6% ( normal 0.5% to 1.5%)
Which of the following are most helpful in diagnosing this patient’s anemia?
A) Serum ferritin
B) Bone marrow biopsy
C) Direct Coombs’ test
D) Hemoglobin Electrophoresis
E) Anti-endomysial antibodies
D.
To r/o thallasemia
microcytic anemia
1. iron deffi.
2. anemia of chronic Dz.
3. Sideroblastic
4. Thallesemia.
D
I think it is D
It must be her absorption of iron…….The only thing is there is no hx of diarrhea. Celiac dis causes malabsorption of iron, so antiendomysial test should be done to rule it out.
ANSWER PLEASE