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Test Showed RBC Slightly Abnormal, MCV Significantly Low And RDW Elevated. Is This Iron Deficiency?

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Posted on Mon, 5 Nov 2012
Question: I'm worried about my nephew, he is 2 years old & as per Docter's advise we did hemoglobin test but in the report some counts came negative but the hemoglobin count seems normal (11.2). In the report the counts which came negative are (rbc count 5.95, mcv count 62.4, rdw 38%. ferrtin 13%). Could you please confirm is this a case of Thalassemia or Iron Deficiency?
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Answered by Dr. Michelle Gibson James (5 hours later)
hi, thanks for using health care magic

In the above results the RBC slightly abnormal, MCV significantly low, the RDW is elevated.In terms of the serum ferritin , to determine whether it is in the normal range you may have to check your lab or refer to the form.It is normally reported in different units ng/ml or mcg/l- the normal range in these units is 7 to 140.

Iron deficiency anemia has a low serum ferritin (this would be diagnostic for iron deficiency- so if you check your reference range and his value is low then it increases the likelihood of iron def anemia), high RDW,an increase in total iron binding capacity
In thalessemia there is not usually an increase in RDW except in a type of thalassemia called thalessemia major.There is also low RBC number, increase in serum iron and serum ferritin which is used in treatment to monitor for iron overload.

Your nephew has an increase in his RDW which may indicate iron def but clarification on the ferritin levels would be necessary to be sure because RDW can also increase in one type of thalassemia.
Your doctor may also consider doing iron binding capacity which increases in iron def anemia and is normal or decreased in thalassemia

I hope this helps, feel free to ask any other questions
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16808 Questions

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Test Showed RBC Slightly Abnormal, MCV Significantly Low And RDW Elevated. Is This Iron Deficiency?

hi, thanks for using health care magic

In the above results the RBC slightly abnormal, MCV significantly low, the RDW is elevated.In terms of the serum ferritin , to determine whether it is in the normal range you may have to check your lab or refer to the form.It is normally reported in different units ng/ml or mcg/l- the normal range in these units is 7 to 140.

Iron deficiency anemia has a low serum ferritin (this would be diagnostic for iron deficiency- so if you check your reference range and his value is low then it increases the likelihood of iron def anemia), high RDW,an increase in total iron binding capacity
In thalessemia there is not usually an increase in RDW except in a type of thalassemia called thalessemia major.There is also low RBC number, increase in serum iron and serum ferritin which is used in treatment to monitor for iron overload.

Your nephew has an increase in his RDW which may indicate iron def but clarification on the ferritin levels would be necessary to be sure because RDW can also increase in one type of thalassemia.
Your doctor may also consider doing iron binding capacity which increases in iron def anemia and is normal or decreased in thalassemia

I hope this helps, feel free to ask any other questions