Microcytic anaemias

The likely causes of a microcytic anaemia are few. In the setting of normal iron studies the only explanation for a microcytic anaemia is thalassaemia, or anaemia inflammationis with concurrent iron deficiency. A low Mentzer index raises suspicion for thalassaemia.

  • Iron deficiency
  • Thalassaemia (usually beta, and sometimes alpha)
  • Anaemia of inflammation

There are also some other rare inherited and acquired causes.

  • Sideroblastic anaemia, and other X-linked anaemias
  • Other haemaglobinopathies
  • Hereditary hypotransferrinaemia
  • Hereditary aceruloplasminaemia
  • Erythropoietic protoporphyria
  • Iron-refractory iron deficiency anaemia
  • SLC11A2 mutations (encoding DMT1)
  • Lead poisoning
  • Zinc deficiency
  • Copper deficiency
  • Alcoholism
  • Some medications
  • MDS with thalassaemia

Required tests

Consider: