How to treat microcytosis with low reticulocyte?

Question

Hello doctor,

My report says reticulocyte count is 0.2 %, hemoglobin is 4.2 g/dl, and RBC shows cytopenia with a dimorphic picture showing moderate microcytic hypochromic with mild microcytosis. What should be the line of treatment? Please suggest.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I am here to extend a helping hand to you.

Based on your query and the attached report (attachment removed to protect the patient's identity), my opinion is as follows:

Low reticulocyte count percentage and reduced hemoglobin indicate hypochromic microcytic anemia, ongoing deficient production.
Looking at moderate microcytosis and mild macrocytosis, it appears it could be more of a nutritional cause.
Correcting iron levels for microcytosis and Vitamin B12 and Folic acid for macrocytosis is essential.
I would suggest you start on Ferrous Fumarate along with Vitamin C for better absorption. Also, Vitamin B12 and Folic acid supplements are essential. Consult your specialist doctor, talk with them, and then take the medications as per their suggestion.
Need to improve the diet rich in iron and vitamins, also to sustain the improvement. Avoid coffee or tea intake with iron supplements, as it can reduce absorption.
Any further fall in hemoglobin or breathlessness should be viewed seriously, and a blood transfusion will be necessary to maintain good cardiac status.
At present, reduced work or more rest is essential to avoid increased cardio-pulmonary load.
Improve nutrition and take supplements, and check reticulocyte count after 15 days; it should be increasing.
If not sure about the nutritional cause, Vitamin B12, Folic acid, and serum iron assay can be done.

I hope it helps.

Any further queries, here to help again.

Thank you.