Non-sideropenic hypochromic anaemia
Sideropenic hypochromic anemia is primarily characterized by low serum iron concentration. Non-sideropenic hypochromic anemia is the ineffective utilisation of iron stores, usually from chronic infection/inflammation. It is very important to distinguish iron deficit anemia from the anemia of chronic disorders so as to ensure specific treatment.
Basic Features
1- Red cell indices and blood film appearances suggest iron deficiency, although peripheral blood changes are not usually as marked as in moderate or severe iron deficiency.
2- Erythropoiesis is abnormal because of ineffective iron utilisation with poor haemoglobinisation of red cell precursors and
3- Bone marrow iron stores are normal or increased and sideroblasts may be frequent and abnormal.
Causes
1- Secondary anemias
- Chronic infection/inflammation
2- Thalassaemia
3- Sideroblastic anaemia
"Differentiation from iron deficiency"
The serum iron and total iron-binding capacity (transferrin) are helpful but not diagnostic; it is quite possible to have co-existing ineffective iron utilisation and iron deficiency, as determined by bone marrow iron status, e.g. in rheumatoid arthritis.
References
1- Aids to clinical haematology (eds; Child J.A. and Cuthbert A.C.ISBN 9780443041921.