What is the most likely cause of hypochromic anisocytosis in a 37 year old multipara construction labourer?
Patient with blood picture showing hypochromic anisocytosis is suffering from dimorphic anemia. Dimorphic anemia result from deficiency of iron along with folic acid/vitamin B12. It is the most common type of anemia in low socioeconomic status people living in the tropics. It can result from dietary inadequacy paicularly during growing periods and in pregnancy, intestinal malabsorption, postgastrectomy syndrome and dietary inadequacy in association with blood loss. Clinical features depend on the degree of anemia. Peripheral smear shows hypochromasia in association with megaloblasts. Ref: Textbook of High Risk Pregnancy By Hemant Deshpande, Page 18 ; Harrison's Principles of Internal Medicine, 18th Edition, Page 450 ; Textbook of Obstetrics By D.C.Dutta, 6th Edition, Pages 265, 272.
Iron deficiency
Folic acid deficiency
Combined iron and folic acid deficiency
Chronic disease