Laboratory findings in iron deficiency anemia, alpha or beta thalassemia, and anemia of chronic disease/anemia of inflammation (ACD/AI)

Test	Iron deficiency anemia	Alpha or beta thalassemia	ACD/AI
Complete blood count
Hemoglobin	Decreased	Normal or decreased	Decreased
Mean corpuscular volume (MCV)	Decreased	Decreased	Normal to decreased
Mean corpuscular hemoglobin concentration (MCHC)	Normal to decreased	Decreased	Normal to decreased
Red cell distribution width (RDW)	Increased	Mildly increased or normal	Normal to increased
RBC count	Decreased	Increased or normal	Decreased
Peripheral blood smear/RBC morphology	Anisocytosis, hypochromia	Anisopoikilocytosis, hypochromia	Normal
Iron studies
Serum iron	Decreased	Normal or increased	Decreased
Total iron-binding capacity (TIBC); transferrin	Increased	Normal	Decreased
Transferrin saturation (TSAT)	Decreased	Normal	Normal to decreased
Serum ferritin	Decreased	Normal or increased	Normal to increased
Erythrocyte protoporphyrin*	Increased	Normal or increased	Increased
Soluble transferrin receptor (sTfR)*	Increased	Increased	Normal
Reticulocyte hemoglobin equivalent (Ret-he or CHr)	Decreased	Decreased	Normal
C-reactive protein	Normal	Normal	Increased
Serum hepcidin*	Decreased	Normal to decreased	Increased
Serum erythropoietin*	Increased	Increased	Normal to moderately increased

Refer to UpToDate topics on anemia for further details of the evaluation and interpretation. Refer to UpToDate topics on iron deficiency anemia for early changes associated with iron deficiency (before anemia develops).

ACD/AI: anemia of chronic disease/anemia of inflammation; RBC: red blood cell.

* Not used in the routine evaluation of anemia. Erythropoietin is not useful unless the hemoglobin is <10 g/dL.

Graphic 65701 Version 10.0

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Laboratory findings in iron deficiency anemia, alpha or beta thalassemia, and anemia of chronic disease/anemia of inflammation (ACD/AI)