A child has Hb-6.5 gm%, MCV-65, MCH-15 and protoporphyria with red cell distribution width much less is most likely to be suffering from :
High-Yield Explanation
Answer is B (Iron deficiency) Microcytic hypochromic anemia with increased levels of red cell protoporphyrin suggests a diagnosis of iron deficiency anemia. Parameter Normal Patient Inference Hb 13-18 gAll 6.5 .t,ed (Anemia) MCV 86-98 pin3 65 ,,ed (microcytosis) MCH 28-33 g/dl 15 led (hypochromia) Protoporphyrin is an intermediate in the pathway of heme synthesis. Under conditions in which synthesis of heme is impaired, protoporphyrin accumulates within the red cell. Protoporphyrin levels thus determine a state of iron deficiency i.e. when there is inadequate iron to combine with protoporphyrin to form haem, the levels of protoporphyrin increases. Normal Iron deficiency (Ted) 30 pg/d1 of red cells 100 pg/d1 of red cells Microcytic hypochromic anemia with increased levels of red cell protoporphyrin is characteristic of iron deficiency anemia, but may also be seen in lead poisoning, anemia of chronic diseases and many cases of sideroblastic anemia. Red cell protoporphyrin will not be increased in Thalassemia as serum iron is normal or increased in them.