A 24-year-old female presents with microcytic anemia. Her Mentzer index (MCV divided by RBC count) is 10.5. Serum ferritin is normal. What is the most likely diagnosis?
Answer and explanation
Correct answer: B. Beta thalassemia minor
- Step 1: In evaluating microcytic anemia, a Mentzer index (MCV/RBC) less than 13 strongly favors thalassemia trait, whereas a ratio greater than 13 indicates iron deficiency.
- Step 2: A Mentzer index of 10.5 with normal iron stores confirms microcytosis due to impaired globin chain synthesis, characteristic of beta thalassemia minor.
Answer
Beta thalassemia minor.
Why not the others: Iron deficiency anemia typically yields a Mentzer index greater than 13 with low serum ferritin and high total iron-binding capacity. Anemia of chronic disease presents with normocytic or mildly microcytic indices with elevated ferritin and low transferrin saturation. Aplastic anemia presents with pancytopenia and normocytic anemia.
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