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Marwa Mostafa: Microcytosis Is Not Always Iron Deficiency
Sep 4, 2026, 04:56

Marwa Mostafa: Microcytosis Is Not Always Iron Deficiency

Marwa Mostafa, Clinical Pathologist at Al-Esraa Medical Center, shared a post on LinkedIn:

“Microcytosis isn’t Iron Deficiency.

When you see a low MCV, iron deficiency may be the first thought – but it’s not the only possibility.

Common causes of microcytosis include:

  • Iron deficiency
  • Thalassemia trait
  • Anemia of chronic inflammation
  •  Sideroblastic anemia

The CBC can give you the first clue, but the RBC count, RDW, iron studies, and clinical context help narrow the differential.

Quick Tip:

A relatively high RBC count despite marked microcytosis can point toward thalassemia trait, while iron deficiency more often shows a lower RBC count and increased RDW.

Don’t diagnose from MCV alone.

Look at the pattern.

What is your go-to parameter when you first see microcytosis?”

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