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CASE 1
60 year-old healthy asymptomatic man, Italian origin. Is here because of "abnormal Labs."
Hgb=12.7, Hct=40.8, Plt=160, WBC=5.7
MCV=63.2 [82.2-97.4], MCH=19.7 [27.6-33.3], MCHC=31.1 [33.0-34.8], RDW=15.2 [11.6-13.7], RBC=6.45 [3.90-5.70]
Physical exam & ROS: unremarkable
Family history: unremarkable (does not recall any family history of anemia)
WHAT IS THE DIANGOSIS:
Note the increased RBC, nl HCT, low MCV, MCH, and MCHC. MCV/RBC<13, MCH/RBC<13, RBC>5, and MCV-(hbx5)-RBC-3.4<0. All these calculations indicate that patient's microcytosis is not secondary to iron deficiency but hemoglobinopathy!
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