photo-1783830036803.jpg
analysis report
Reading File
Finding Sources
Finding Sources
Reading File
Reading File
I now have all the information needed to produce a thorough analysis. Here is the complete report:
CBC Analysis Report
Patient: MURIBEN DAYABHAI | Age/Sex: 78 Years / Female
Referred by: Dr. Dhvanish Vyas, MD (Medicine) | Date: 10/07/2026
Lab: Aastha Diagnosis / Prism Pathology Laboratory, Rajkot
Summary of Results with Interpretation
| Test | Result | Reference Range | Status |
|---|---|---|---|
| Haemoglobin | 11.6 g% | 12.0 - 16.0 | π΄ LOW |
| Total RBC | 4.31 mill/c.mm | 4.2 - 5.4 | β Normal |
| Total WBC | 8920 /cu.mm | 4000 - 10000 | β Normal |
| Platelet Count | 2,79,000 /cu.mm | 150000 - 450000 | β Normal |
| Neutrophils | 70% | 40 - 70 | β Normal (upper limit) |
| Lymphocytes | 26% | 20 - 40 | β Normal |
| Eosinophils | 02% | 1 - 4 | β Normal |
| Monocytes | 02% | 3 - 8 | π‘ Low-normal |
| Basophils | 00% | 0 - 1 | β Normal |
| ANC | 6244 /uL | 1600 - 7000 | β Normal |
| Absolute Lymphocyte Count | 2319.2 /uL | 800 - 4000 | β Normal |
| Absolute Eosinophil Count | 178.4 /uL | 0 - 450 | β Normal |
| Absolute Monocyte Count | 178.4 /uL | 200 - 1000 | π‘ Mildly low |
| PCV (Hematocrit) | 36.4% | 37 - 47 | π΄ LOW |
| MCV | 84.45 fL | 78 - 100 | β Normal |
| MCH | 26.91 pg | 27 - 31 | π΄ LOW |
| MCHC | 31.9% | 32 - 36 | π΄ LOW |
| RDW | 16.3% | 11.5 - 14.0 | π΄ HIGH |
| Mentzer Index | 19.59 | >13: IDA / <13: Beta-Thal | β οΈ Suggests IDA |
Key Findings and Clinical Interpretation
1. Mild Anemia
Haemoglobin is 11.6 g% (normal for women: 12.0-16.0 g%). The PCV (hematocrit) is also mildly reduced at 36.4%. This constitutes mild anemia by WHO criteria (Hb 10-11.9 g/dL in women).
2. Anemia Pattern: Normocytic with Hypochromia
- MCV is 84.45 fL (normal range 78-100 fL) - normocytic
- MCH is 26.91 pg (below normal 27-31 pg) - mildly hypochromic
- MCHC is 31.9% (below normal 32-36%) - hypochromic
This combination of normocytic but hypochromic red cells can be seen in early or mild iron deficiency anemia before the MCV drops, or in anemia of chronic disease - common in elderly patients.
3. Elevated RDW - Strong Pointer Toward Iron Deficiency
RDW is 16.3% (normal 11.5-14.0%), which is significantly elevated. As noted in Harrison's Principles of Internal Medicine (22nd ed.), "In iron deficiency, the size variability and the RDW are large," whereas in thalassemia the RDW tends to be normal or only mildly elevated with uniform small cells. A raised RDW with hypochromia strongly points toward Iron Deficiency Anemia (IDA).
4. Mentzer Index: 19.59 - Confirms IDA Over Thalassemia
The Mentzer Index = MCV / RBC count = 84.45 / 4.31 = 19.59
- >13 favors Iron Deficiency Anemia (IDA)
- <13 favors Beta-Thalassemia trait
An index of 19.59 strongly suggests IDA rather than thalassemia as the underlying cause. As per Quick Compendium of Clinical Pathology (5th ed.): "MCV:RBC ratio (Mentzer index) <13 favors thalassemia, while a ratio >15 favors iron deficiency."
5. White Cell and Platelet Count: Normal
- Total WBC 8920/cu.mm is within normal limits
- No leukocytosis to suggest active infection or hematologic malignancy
- Platelet count 2,79,000/cu.mm is normal (confirmed on smear)
- Differential is unremarkable
Probable Diagnosis
Mild Iron Deficiency Anemia (IDA) - early/mild stage (normocytic-hypochromic pattern with elevated RDW and Mentzer Index >13)
This is very common in elderly women and can result from:
- Inadequate dietary iron intake
- Chronic occult gastrointestinal blood loss (e.g., peptic ulcer, colonic lesion, NSAID use)
- Malabsorption
- Chronic kidney disease (in the elderly)
Recommended Next Steps
- Serum Iron, TIBC, Transferrin Saturation, and Serum Ferritin - to confirm iron deficiency (ferritin is the most sensitive early marker)
- Peripheral Blood Smear - to assess red cell morphology (pencil cells, target cells), though already performed automated
- Reticulocyte Count - to assess bone marrow response
- Renal Function Tests (BUN, Creatinine) - given age 78, to rule out anemia of chronic kidney disease
- Stool Occult Blood Test - to rule out GI blood loss, especially in this age group
- Upper GI Endoscopy / Colonoscopy - if occult blood positive or clinical suspicion of GI malignancy (age 78 warrants this)
- Vitamin B12 and Folate levels - to rule out coexisting nutritional deficiency (dimorphic anemia can present with normal MCV)
Important Notes for the Treating Physician
- The normal MCV despite hypochromia and elevated RDW is a classic early-stage IDA pattern - the MCV drops later as iron stores are further depleted
- At age 78, new onset anemia should always prompt evaluation for an underlying cause - do not simply treat with iron without investigating the source
- The Goldman-Cecil Medicine textbook notes: "A normal RDW in microcytic anemia is more likely to represent a hemoglobinopathy or thalassemia rather than iron deficiency" - here the RDW is elevated, further supporting IDA
- No features of hemolysis, leukemia, or pancytopenia are present
This report is an AI-assisted interpretation for clinical support only. Final diagnosis and management must be made by the treating physician in correlation with clinical findings. - Goldman-Cecil Medicine; Harrison's Principles of Internal Medicine 22E (2025)
This is a shared conversation. Sign in to Orris to start your own chat.