THE RED CELL INDICES IN THE DIAGNOSIS OF IRON-DEFICIENCY ANEMIA

Abstract

Most of the red cell indices of 80 patients indicated the presence of hypochromia and microcytosis, but among the less severely anemic patients, normal red cell indices were common. On examination of stained smears, experienced observers were able to detect abnormalities of the red cells of some of these subjects, but no observer was able to detect abnormalities in all of them. The same observers missed abnormalities on smears from some patients whose red cell indices clearly indicated the presence of hypochromia and microcytosis. Examination of stained smears was therefore not clearly superior to determination of red cell indices. It is concluded that, while determination of red cell indices and examination of stained smears are important, one cannot exclude the diagnosis of iron deficiency on the basis of normal red cell indices or normal appearance of red cells on the smear alone. This is particularly true in the case of mildly anemic patients.