Int J Cur Res Rev | Vol 14 • Issue 08 • April 2022 1 The Role of Iron Profile in the Differential Diagnosis of Microcytic Hypochromic Anemia in King Abdulaziz Medical City Mohieldin Elsayid 1,3 , Rasha Mohammad Al-ghamdi 1 , Atheer Mubarak Al-ghamdi 1 , Naif M. Alhawiti 1,3 , Alotibi R S 1,3 , Ghadeer Nabeel Muglad 1 , Amir Abushouk 2 , Mohamed E. Ahmed 4 , Naif S. Sannan 1,3* 1 Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences; 2 College of Medicine, King Saud bin Abdulaziz University for Health Sciences; 3 King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; 4 College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences. Corresponding Author: Dr. Naif S. Sannan, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences; King Abdullah international medical research center, Jeddah, Saudi Arabia; Email: sannann@ksau-hs.edu.sa ISSN: 2231-2196 (Print) ISSN: 0975-5241 (Online) Received: 07.02.2022 Revised: 25.02.2022 Accepted: 18.03.2022 Published: 19.04.2022 INTRODUCTION Anemia is a very common condition and defined as an abnor- mal decrease in the total red blood cells (RBCs). 1 According to the world health organization, anemia affects 24.8% of the human population. 2,3 A recent study conducted on pregnant women indicated that 41.8% are affected. 2 According to a study conducted in Ethiopia, 11.5 percent of pregnant wom- en were affected. 4 Another study of 1573 men, women, and children found that 13% of men and nearly half of women and children had iron deficiency. 5 Furthermore, a number of studies support the high prevalence of anemia. 6,7,8,9 Anemia has several types and can be classified according to RBCs’ morphology into three major classes. 2,10,11,12 Macro- cytic anemia (large RBCs), normocytic anemia (normal RBCs size), and microcytic anemia (small RBCs). 12 Microcytic anemia is subdivided into hypochromic, normochromic, and hyperchromic in respect to the hemoglobin amount in the RBCs.Hemoglobin is a protein with four peptides responsi- ble for RBCs redness and gas transportation, and it has iron as one of its important components. 2,12 Generally, anemia is a consequence of iron deficiency which leads to a decrease in hemoglobin production; however, pathogenesis may differ in some microcytic hypochromic anemia. 1,12 Thalassemia, for Research Article International Journal of Current Research and Review DOI: http://dx.doi.org/10.31782/IJCRR.2022.14801 IJCRR Section: Healthcare ISI Impact Factor (2021-22): 2.176 IC Value (2020): 91.47 SJIF (2020) = 7.893 Copyright@IJCRR ABSTRACT Introduction: Anemia is an abnormal decrease in red blood cells (RBCs) and is classified as; macrocytic, normocyticor micro- cytic. Iron profiling along with complete blood counting (CBC) is performed to diagnose microcytic hypochromic anemia (MCA). Aims: To evaluate the role of iron profile in differentiating MHA. Methodology: Retrospective chart-review study conducted in 2019 on anemic patients attending King Abdulaziz Medical City. Values from CBC and iron profiling tests were collected. Results: 219 patients with MHA, 164 females and 55 males, were identified. Female patients were 74.9% of all cases, and adults were the most affected. Values of CBC parameters including hemoglobin, RBCs, packed cells volume (hematocrit), mean cell volume and mean cell hemoglobin were significantly lower in cases than controls (p<0.001). Iron profiling showed a signifi- cant association between all parameters and the diagnosis of iron deficiency anemia (IDA) and anemia of chronic disease, but not with TIBC. Iron profile values in thalassemia showed a significant association between diagnosis and serum iron and ferritin only. In sideroblastic anemia, iron profile values showed a significant association between all parameters except for transferrin. Conclusion: IDA and anemia from chronic diseases are the highest among MHA. Iron profiling plays an important role in dif- ferentiating MHA. Key Words: Anemia, Microcytic Hypochromic anemia, Thalassemia, Iron deficiency anemia, Anemia of chronic disease, Sideroblastic anemia, Complete blood count (CBC), Iron Profile test