Microcytosis is a term that can be found in the blood count report that indicates that the red blood cells are smaller than normal, and the presence of microcytic red blood cells may also be indicated in the blood count. Microcytosis is evaluated through the MCV or Mean Corpuscular Volume index, which indicates the average size of red blood cells, with a reference value between 80.0 and 100.0 fL, however this value may vary according to the laboratory.
In order for microcytosis to be of clinical importance, it is recommended that the MCV result be interpreted together with other indices measured in the blood count, such as Mean Corpuscular Hemoglobin (MCH), amount of hemoglobin, Mean Corpuscular Hemoglobin Concentration (CHCM) and RDW, which is the index that indicates the variation in size between red blood cells. Learn how to understand the blood count.
What does discrete microcytosis mean?
Discrete microcytosis is a term that may be present in the hemogram report when it is verified that only the MCV is altered and the value is close to the reference value, not being taken into account in the interpretation of the hemogram, since it corresponds to a situation momentary.
However, when the values are very low, it is important to check if any other index is altered. If the other indices evaluated in the blood count are normal, it is recommended to repeat the blood count.
Main causes of microcytosis
Microcytosis is mainly related to nutritional changes or happens due to situations that influence the formation of hemoglobin. Thus, the main causes of microcytosis are:
1. Thalassemia
Thalassemia is a genetic disease characterized by alteration in the process of hemoglobin synthesis, in which there is a mutation in one or more globin chains, resulting in functional alterations of red blood cells. In addition to the altered MCV, it is likely that other indices are also altered, such as HCM, CHCM, RDW and hemoglobin.
As there is a change in the process of hemoglobin formation, the transport of oxygen to the tissues is also altered, since hemoglobin is responsible for this process. Thus, some symptoms of thalassemia arise, such as tiredness, irritability, pallor and alteration in the respiratory process. Know how to recognize the signs and symptoms of thalassemia.
2. Hereditary spherocytosis
Hereditary or congenital spherocytosis is a disease characterized by changes in the red blood cell membrane, making them smaller and less resistant, with a higher rate of red blood cell destruction. Thus, in this disease, in addition to other changes, a lower number of red blood cells and a decreased MCV can be observed.
As the name itself says, spherocytosis is hereditary, that is, it passes from generation to generation and the person is already born with this change. However, the severity of the disease can vary from person to person, and it is important to start treatment soon after birth according to the guidance of the hematologist.
3. Infections
Chronic infections can also result in microcytic red blood cells, because the permanence of the agent responsible for the infection in the body can result in nutritional deficiencies and changes in the immune system, altering not only hematological indices but also other laboratory parameters.
To confirm the infection, it is important for the doctor to request and evaluate other laboratory tests, such as C-Reactive Protein (CRP), urinalysis and microbiological examination. The blood count may be suggestive of infection, but other tests are needed to confirm the diagnosis and initiate appropriate treatment.
4. Iron deficiency anemia
Iron deficiency anemia, also called iron deficiency anemia, is characterized by low amounts of iron circulating in the blood due to iron-poor diet or as a consequence of bleeding or severe menstruation, for example.
The decrease in the amount of iron directly interferes with the amount of hemoglobin, since it is fundamental in the process of hemoglobin formation. Thus, in the absence of iron, there is a decrease in the amount of hemoglobin, leading to the emergence of some signs and symptoms, such as weakness, frequent tiredness, feeling faint, hair loss, weakening of the nails and lack of appetite, for example.
Most cases of iron deficiency anemia occur as a result of nutritional deficiencies. Thus, the solution is to change eating habits, increasing the consumption of foods rich in iron, such as spinach, beans and meat. See how to treat iron deficiency anemia.
5. Anemia of Chronic Disease
Anemia of chronic disease is a common type of anemia to occur in patients who are hospitalized, with not only changes in the value of MCV, but also of HCM, CHCM, RDW and hemoglobin. This type of anemia is more frequent in patients with chronic infections, inflammatory diseases and neoplasms.
As this type of anemia usually occurs during treatment, diagnosis and treatment are established immediately to avoid further complications for the patient. Learn more about anemia of chronic disease.
