hypochromic anemia


Summary: Anemia characterized by a decrease in the ratio of the weight of hemoglobin to the volume of the erythrocyte, i.e., the mean corpuscular hemoglobin concentration is less than normal. The individual cells contain less hemoglobin than they could have under optimal conditions. Hypochromic anemia may be caused by iron deficiency from a low iron intake, diminished iron absorption, or excessive iron loss. It can also be caused by infections or other diseases, therapeutic drugs, lead poisoning, and other conditions. (Stedman, 25th ed; from Miale, Laboratory Medicine: Hematology, 6th ed, p393)

Top Publications

  1. Sakamoto D, Kudo H, Inohaya K, Yokoi H, Narita T, Naruse K, et al. A mutation in the gene for delta-aminolevulinic acid dehydratase (ALAD) causes hypochromic anemia in the medaka, Oryzias latipes. Mech Dev. 2004;121:747-52 pubmed publisher
    ..affecting embryogenesis in the medaka, Oryzias latipes, identified a mutant, whiteout (who), that exhibited hypochromic anemia. The who mutant initially had the normal number of blood cells, but it then gradually decreased during the ..
  2. Zhu B, McLaughlin S, Na R, Liu J, Cui Y, Martin C, et al. Hematopoietic-specific Stat5-null mice display microcytic hypochromic anemia associated with reduced transferrin receptor gene expression. Blood. 2008;112:2071-80 pubmed publisher
    ..These mice exhibited microcytic, hypochromic anemia, as did lethally irradiated mice that received a transplant of Stat5a/b(-/-) fetal liver cells...
  3. Aulakh R, Sohi I, Singh T, Kakkar N. Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia. Indian J Pediatr. 2009;76:265-8 pubmed publisher
    ..of red cell distribution width (RDW) in the diagnosis of iron deficiency among children with microcytic hypochromic anemia. 151 children (6 months-12 years) with microcytic (MCV<75 fl) anemia were classified into iron deficient (..
  4. Sankar V, Arya V, Tewari D, Gupta U, Pradhan M, Agarwal S. Genotyping of alpha-thalassemia in microcytic hypochromic anemia patients from North India. J Appl Genet. 2006;47:391-5 pubmed
    Microcytic hypochromic anemia is a common condition in clinical practice and alpha-thalassemia has to be considered as a differential diagnosis. Molecular diagnosis of alpha-thalassemia is possible by polymerase chain reaction...
  5. Bannerman R, Cooper R. Sex-linked anemia: a hypochromic anemia of mice. Science. 1966;151:581-2 pubmed
    ..Though the anemia occurs on a normal diet, it responds rapidly to iron-dextran injection. It may represent an unusual primary disturbance of iron metabolism. ..
  6. Rahim F. Microcytic hypochromic anemia patients with thalassemia: genotyping approach. Indian J Med Sci. 2009;63:101-8 pubmed
    Microcytic hypochromic anemia is a common condition in clinical practice, and alpha-thalassemia has to be considered as a differential diagnosis...
  7. Lyoumi S, Abitbol M, Andrieu V, Henin D, Robert E, Schmitt C, et al. Increased plasma transferrin, altered body iron distribution, and microcytic hypochromic anemia in ferrochelatase-deficient mice. Blood. 2007;109:811-8 pubmed
    ..FECH deficiency induced microcytic hypochromic anemia without ringed sideroblasts, little or no hemolysis, and no erythroid hyperplasia...
  8. Lövey J, Kenessey I, Raso E, Dobos J, Vágó A, Kasler M, et al. [Human recombinant erythropoietin-alpha increases the efficacy of irradiation in preclinical model]. Magy Onkol. 2007;51:53-61 pubmed
  9. Sandmann M, Fähndrich M, Heike M. ["Endoscopy in a stone quarry"--multiple pigment stones 6 weeks after delivery]. Z Gastroenterol. 2010;48:401-5 pubmed publisher
    ..HbC is a structurally abnormal hemoglobin with typical aggregates and tetragonal crystal formation which results in mild chronic hemolytic anemia. The cholezystectomy after 6 weeks was performed without complications. ..

More Information


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    ..Thus, both the structure and assembly of the TMV CP function as determinants in the induction of disease and resistance responses. ..
  2. Fleming M, Romano M, Su M, Garrick L, Garrick M, Andrews N. Nramp2 is mutated in the anemic Belgrade (b) rat: evidence of a role for Nramp2 in endosomal iron transport. Proc Natl Acad Sci U S A. 1998;95:1148-53 pubmed
    The Belgrade (b) rat has an autosomal recessively inherited, microcytic, hypochromic anemia associated with abnormal reticulocyte iron uptake and gastrointestinal iron absorption...
  3. Remacha A, Sarda M, Parellada M, Ubeda J, Manteiga R. The role of serum transferrin receptor in the diagnosis of iron deficiency. Haematologica. 1998;83:963-6 pubmed
    ..Iron treatment should be considered in patients with mixed patterns of iron status, in which the diagnosis of IDA versus ACD is difficult, when the levels of sTfR exceed the cut-off point. ..
  4. Tsatalas C, Chalkia P, Pantelidou D, Margaritis D, Bourikas G, Spanoudakis E. Pregnancy in beta-thalassemia trait carriers: an uneventful journey. Hematology. 2009;14:301-3 pubmed publisher
    ..Anemia in beta-thal carriers is generally not severe enough to warrant anxiety. No specific therapy is indicated and pregnant women generally require only supportive care with an anticipated favorable pregnancy outcome. ..
  5. Tsukahara T, Ezaki T, Moriguchi J, Furuki K, Ukai H, Okamoto S, et al. Effects of iron-deficiency anemia on cadmium uptake or kidney dysfunction are essentially nil among women in general population in Japan. Tohoku J Exp Med. 2002;197:243-7 pubmed
    ..Thus, it appeared likely that the current level of iron insufficiency among general women population in Japan may not induce substantial increase in Cd absorption or Cd-associated kidney dysfunction. ..
  6. Delb W, Koch A, Federspil P. Experimental investigations on the influence of anemia on gentamicin ototoxicity. Eur Arch Otorhinolaryngol. 1991;248:342-4 pubmed
    ..05) than in the nonanemic ones treated with the same dosages of antibiotic. Doses of gentamicin used were 50 mg/kg for 30 days and 40 mg/kg for another 75 days. ..
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    ..This case report demonstrates the need of early diagnosis and treatment of congenital atransferrinemia to prevent the mentioned complications. ..
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    ..Particular attention has been paid to necessity of periodic endoscopic investigations of the gastrointestinal tract with concurrent polyp resection. ..
  9. Kumar Yadav A, Rusia U. HbQ-India associated with microcytosis: An uncommon hemoglobin variant associated with a common hematologic condition. Turk J Haematol. 2010;27:200-3 pubmed publisher
    ..Complete blood count showed severe microcytic hypochromic anemia. Hemoglobin electrophoresis showed a prominent band in the S,D,G region. Tests for sickling were negative...
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  12. Suzuki M, Nakagawa M, Shimizu Y, Suemura M, Sato B. [Therapy-resistant microcytic hypochromic anemia from malabsorption-related vitamin B6 deficiency after a gastrointestinal operation]. Rinsho Ketsueki. 2005;46:1044-8 pubmed
    ..Some reports say that B6 deficiency causes microcytic hypochromic anemia, since B6 is necessary for erythrocytic hemopoiesis as a coenzyme for heme biosynthesis...
  13. Miller L, Chan W, Comfort K, Tirella L. Health of children adopted from Guatemala: comparison of orphanage and foster care. Pediatrics. 2005;115:e710-7 pubmed
    ..These findings support the need for timely adoptive placement of young infants and support the placement of children in attentive foster care rather than orphanages when feasible. ..
  14. Ma S, Ma V, Chan A, Chan L, Chui D. Routine screening of (--(SEA)) alpha-thalassemia deletion by an enzyme-linked immunosorbent assay for embryonic zeta-globin chains. Acta Haematol. 2002;108:8-12 pubmed
    ..In areas with a high prevalence of alpha-thalassemia, improved detection of SEA deletion carriers would ultimately facilitate the identification of pregnancies at risk of hydrops fetalis and its prevention through prenatal diagnosis. ..
  15. Islek I, Kucukoduk S, Cetinkaya F, Gurses N. Effects of ascaris infection on iron absorption in children. Ann Trop Med Parasitol. 1993;87:477-81 pubmed
    ..It therefore appears that Ascaris infection does not lead to iron malabsorption and iron deficiency anaemia in children. ..
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    ..37; P less than 0.05). A significant correlation was found between serum TF levels and plasma IGF-1 levels (r = 0.45; P less than 0.05). These data indicate that serum TF levels may be a marker of skeletal growth in normal boys. ..
  17. Beamer W, Pelsue S, Shultz L, Sundberg J, Barker J. The flaky skin (fsn) mutation in mice: map location and description of the anemia. Blood. 1995;86:3220-6 pubmed
    ..The mechanism whereby fsn induces the reported pleiotropic effects has yet to be elucidated. ..
  18. Phylipsen M, Prior J, Lim E, Lingam N, Finlayson J, Arkesteijn S, et al. Two new alpha1-globin gene point mutations: Hb Nedlands (HBA1:c.86C>T) [alpha28(B9)Ala-->Val] and Hb Queens Park (HBA1:c.98T>A) [alpha32(B13)Met-->Lys]. Hemoglobin. 2010;34:123-6 pubmed publisher
    ..98T>A, Hb Queens Park [alpha32(B13)Met-->Lys] which seems to be associated with a mild alpha-thalassemia (alpha-thal) phenotype. The phenotype/genotype correlation is briefly described. ..
  19. Macdougall I, Roche A. Administration of intravenous iron sucrose as a 2-minute push to CKD patients: a prospective evaluation of 2,297 injections. Am J Kidney Dis. 2005;46:283-9 pubmed
    ..Traditionally, this has been administered as an infusion over 1 or more hours, which requires the use of intravenous fluids and administration tubing, along with extra demands on patient and nursing time...
  20. Santili C, Akkari M, Waisberg G, Kessler C, Alcantara T, Delai P. Calcinosis universalis: a rare diagnosis. J Pediatr Orthop B. 2005;14:294-8 pubmed
  21. Potter U, Bartrop R, Touyz S. Pubertal process and green-sickness in Renaissance drama: a form fruste of anorexia nervosa?. Australas Psychiatry. 2009;17:380-4 pubmed publisher
    ..Affluence and improved nutrition were recognized as contributory factors. The development of both green-sickness and anorexia nervosa appear to share a common theme in the context of puberty. ..
  22. Yamaguchi K. [Isoferritin]. Nihon Rinsho. 2005;63 Suppl 8:736-40 pubmed
  23. Reed N, Morere J. Optimising anaemia management with epoetin beta. Oncology. 2004;67 Suppl 1:12-6 pubmed
    ..Once weekly administration of epoetin beta offers greater convenience and should reduce administration costs compared with the tiw regimen. ..
  24. Baillie F, Morrison A, Fergus I. Soluble transferrin receptor: a discriminating assay for iron deficiency. Clin Lab Haematol. 2003;25:353-7 pubmed
    ..Measurement of sTfR may be a useful addition in the differential diagnosis of ACD and IDA. ..
  25. Harrison D. Marrow transplantation and iron therapy in mouse hereditary microcytic anemia. Blood. 1972;40:893-901 pubmed
  26. Souqiyyeh M, Shaheen F. Attitude of physicians in Saudi Arabia towards anemia treatment strategies in patients with chronic kidney disease. Saudi J Kidney Dis Transpl. 2007;18:65-72 pubmed
    ..More studies are required to explore the quality of services rendered to the CKD patients and guidelines need to be outlined for the management of anemia in the CKD patients. ..
  27. Usberti M, Gerardi G, Micheli A, Tira P, Bufano G, Gaggia P, et al. Effects of a vitamin E-bonded membrane and of glutathione on anemia and erythropoietin requirements in hemodialysis patients. J Nephrol. 2002;15:558-64 pubmed
    ..Since several antioxidant systems are impaired in uremia, the combined use of the CL-E membrane and GSH seems to be the best antioxidant therapy so far, with significant saving of the rhEPO dose. ..
  28. Barman Aksoezen J, Girelli D, Aurizi C, Schneider Yin X, Campostrini N, Barbieri L, et al. Disturbed iron metabolism in erythropoietic protoporphyria and association of GDF15 and gender with disease severity. J Inherit Metab Dis. 2017;40:433-441 pubmed publisher
    ..In addition to photosensitivity, patients frequently exhibit low serum iron and a microcytic hypochromic anemia. The aims of this study were to (1) search for factors related to PPIX concentration in EPP, and (2) ..
  29. Yalcin A, Avcu F, Beyan C, Gurgey A, Ural A. A case of HB J-Meerut (or Hb J-Birmingham) [alpha 120(H3)Ala-->Glu]. Hemoglobin. 1994;18:433-5 pubmed
  30. Katodritou E, Speletas M, Zervas K, Kapetanos D, Georgiou E, Christoforidou A, et al. Evaluation of hypochromic erythrocytes in combination with sTfR-F index for predicting response to r-HuEPO in anemic patients with multiple myeloma. Lab Hematol. 2006;12:47-54 pubmed
  31. Alonso Cotoner C, Casellas Jordá F, Chicharro Serrano M, de Torres Ramirez I, Malagelada Benaprés J. [Iron deficiency: not always blood losses]. An Med Interna. 2003;20:227-31 pubmed
    ..5%) and 35(53%) patients remained without a definitive diagnosis. Jejunal biopsy is useful in the evaluation of iron deficiency due to intestinal malabsorption and reveals intestinal abnormalities in a significant number of cases. ..
  32. Pujade Lauraine E, Topham C. Once-weekly treatment of anemia in patients with cancer: a comparative review of epoetins. Oncology. 2005;68:122-9 pubmed
    ..The improved convenience and reduced administration costs associated with a once-weekly treatment may result in more patients receiving the benefits of epoetin therapy. ..
  33. Dooley K, Fraenkel P, Langer N, Schmid B, Davidson A, Weber G, et al. montalcino, A zebrafish model for variegate porphyria. Exp Hematol. 2008;36:1132-42 pubmed publisher
    ..a genetic screen for hematopoietic mutants, we isolated a zebrafish mutant, montalcino (mno), which displays hypochromic anemia and porphyria...
  34. Birgegard G, Aapro M, Bokemeyer C, Dicato M, Drings P, Hornedo J, et al. Cancer-related anemia: pathogenesis, prevalence and treatment. Oncology. 2005;68 Suppl 1:3-11 pubmed
    ..These findings are noteworthy, since a growing body of clinical evidence indicates that the treatment of anemia can significantly improve patients' quality of life and may also improve the clinical outcome. ..
  35. Bredenkamp J, Castro D, Mickel R. Importance of iron repletion in the management of Plummer-Vinson syndrome. Ann Otol Rhinol Laryngol. 1990;99:51-4 pubmed
    ..The occurrence of glossitis, gastritis, and esophagitis in iron deficiency demonstrates the adverse effects of iron depletion on the rapidly proliferating cells of the upper alimentary tract. ..
  36. Rector W. Pica: its frequency and significance in patients with iron-deficiency anemia due to chronic gastrointestinal blood loss. J Gen Intern Med. 1989;4:512-3 pubmed
    ..30/46), but this difference was not significant. Pica, a frequent symptom in patients with iron-deficiency anemia due to gastrointestinal blood loss, particularly women, is not of value in predicting the cause of bleeding. ..
  37. Fleming A. The aetiology of severe anaemia in pregnancy in Ndola, Zambia. Ann Trop Med Parasitol. 1989;83:37-49 pubmed
    ..Because of the risk of transmission of human immunodeficiency virus, it is more important than ever to prevent anaemia and malaria in pregnancy, and to give blood transfusion only as a life-saving treatment. ..
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  39. Vreugdenhil G, Baltus J, van Eijk H, Swaak A. Prediction and evaluation of the effect of iron treatment in anaemic RA patients. Clin Rheumatol. 1989;8:352-62 pubmed
    ..Iron treatment is only useful in iron deficient RA patients, although active RA limits maximal Hb rise. In contrast to earlier findings, iron treatment had no deleterious effects on disease activity. ..
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    ..It helps to guide further investigations of the bleeding site. This non invasive method should be performed more quickly to help to localize intestinal bleeding which poses a diagnostic problem...
  41. Bannerman R, Edwards J, Kreimer Birnbaum M, McFarland E, Russell E. Hereditary microcytic anaemia in the mouse; studies in iron distribution and metabolism. Br J Haematol. 1972;23:235-45 pubmed
  42. Perdahl Wallace E, Schwartz R. A girl with green complexion and iron deficiency: chlorosis revisited. Clin Pediatr (Phila). 2006;45:187-9 pubmed
  43. Rampertab S, Pooran N, Brar P, Singh P, Green P. Trends in the presentation of celiac disease. Am J Med. 2006;119:355.e9-14 pubmed
    ..8% vs 8.9%, P = .71). There is a trend toward fewer patients presenting with symptomatic celiac disease characterized by diarrhea and a significant shift toward more patients presenting as asymptomatic adults detected at screening. ..
  44. Milman N, Byg K, Mulvad G, Pedersen H, Bjerregaard P. Haemoglobin concentrations appear to be lower in indigenous Greenlanders than in Danes: assessment of haemoglobin in 234 Greenlanders and in 2804 Danes. Eur J Haematol. 2001;67:23-9 pubmed
    ..0001) and in women (p<0.0001). Delta(mean haemoglobin) in men was 8.0 g/L (0.5 mmol/L) and in women 6.2 g/L (0.4 mmol/L). Variations in haemoglobin levels may be due to genetic differences. ..
  45. Wang J, Hashmi G. Elevated thrombopoietin levels in patients with myelofibrosis may not be due to enhanced production of thrombopoietin by bone marrow. Leuk Res. 2003;27:13-7 pubmed
    ..The TPO receptor (c-MPL) abnormalities including reduced MPL protein levels or defective TPO induced signal transduction pathways are the likely mechanisms. ..
  46. McElrone A, Grant J, Kluepfel D. The role of tyloses in crown hydraulic failure of mature walnut trees afflicted by apoplexy disorder. Tree Physiol. 2010;30:761-72 pubmed publisher
    ..In 2008, tylose development was associated with elevated ethylene production in the active sapwood of symptomatic trees. The cause of elevated ethylene associated with tylose production and symptom formation is yet to be determined. ..
  47. Bernstein S. Hereditary hypotransferrinemia with hemosiderosis, a murine disorder resembling human atransferrinemia. J Lab Clin Med. 1987;110:690-705 pubmed
    ..of inheritance, and both are early onset lethal diseases in which homozygotes have refractory iron-deficient hypochromic anemia. Their plasma transferrin levels are less than 4 mg/dl, and extensive deposits of iron are found in the ..
  48. Noto R, Meli S, Noto Z, Rapisarda A, Noto P, Molino G. Rhabdomyolysis as the epiphenomenon of unrecognised celiac sprue. Panminerva Med. 2003;45:273-4 pubmed
  49. Simon T. Iron, iron everywhere but not enough to donate. Transfusion. 2002;42:664 pubmed
  50. Koong A, Hirst D. The influence of chronic anaemia on the radiosensitivity of two mouse tumours. Br J Cancer. 1991;63:499-502 pubmed
    ..2 X 10(4) cells g-1 surviving a dose of 20 Gy compared with 6.7 x 10(4) g-1 in controls (P less than 0.01). These results are consistent with most published data for mouse tumours though not for many human tumours. ..
  51. Lacan P, Moreau M, Becchi M, Zanella Cleon I, Aubry M, Louis J, et al. Two new hemoglobin variants: Hb Brem-sur-Mer [beta9(A6)Ser-->Tyr] and Hb Passy [alpha81(F2)Ser-->Pro (alpha2)]. Hemoglobin. 2005;29:69-75 pubmed
    ..In the absence of an association with an alpha-thalassemic deletion or mutation, the mutation 81(F2)Pro could induce a possible alpha-thalassemia (thal). ..
  52. Moumni I, Zorai A, Daoued B, Mosbahi I, Omar S, Kaabachi N, et al. Hb A2-Pasteur-Tunis [delta59(E3)Lys-->Asn, AAG-->AAC]: a new delta chain variant detected by DNA sequencing in a Tunisian carrier of the codon 39 (C-->T) beta0-Thalassemia mutation. Hemoglobin. 2007;31:23-9 pubmed
    ..Phenotype and genotype investigations revealed that the total Hb A2 level of the patient was that expected for a minor beta-thal (4.8%). ..
  53. Ferreira C, Hoyer J, Miranda A, Picanço I, Almendra V, Seixas M, et al. Hemoglobin Loves Park [beta68 (E12) Leu-->Phe]: report of five cases including one originating from a de novo mutation. Am J Hematol. 2006;81:256-61 pubmed
    ..Functional studies revealed that Hb Loves Park is stable and has a decreased oxygen affinity. ..