A student from Punjab presents for evaluation of anemia. His RDW was observed to be 13.5 while the MCV was 62.5. fl. The likely diagnosis is

Ans. is 'd' i.e., Anemia of chronic disease The normal red cell distrubution width (RDW) is less than 14.5 (Ranges from 11.5 to 14.5 but there is no known cause of decreased RDW). Normal MCV varies from 79.93.3 ft. The patient in question therefore has a Reduced MCV and a Normal RDW. Low MCV along with normal RDW suggests a diagnosis of Anemia of chronic disease. Conditions with Reduced MCV and a Normal RDW o Anemia of Chronic disease Beta thalasemia Minor/Trait Alpha Thalassemia Minor/Trait Hemoglobin E Trait Note : Thalassemia Trait - Low MCV: Normal RDW Anemia of chronic disease - Low MCV : Normal RDW or Normal MCV and Normal RDW Iron deficiency Anemia - Low MCV : Increased RDW