A hypochromic microcytic anemia

A 18-year-old man, of Italian extraction, is found to have a hypochromic microcytic anemia of 10 g/dL. In addition, there is a fair degree of anisocytosis, poikilocytosis, and targeting on the blood film. The WBC is 9500/mL, the platelet count is 240,000/mL, and the reticulocyte count is 7%. The spleen is palpated 5 cm below the left costal margin. Which of the following is the most likely diagnosis?

(A) sickle cell trait
(B) thalassemia minor
© HbS-C disease
(D) sideroblastic anemia
(E) hereditary spherocytosis


(B) Thalassemia minor usually represents a heterozygous state and is often asymptomatic. Symptoms may develop during periods of stress such as pregnancy or severe infection. Hemoglobin values are usually in the 9–11 g/dL range. The red cells are small and poorly hemoglobinized