A patient with iron deficiency anaemia is started on oral ferrous sulphate 200 mg three times daily. The earliest objective marker of a correct diagnosis and adequate response, expected within the first week, is:
- A Peak reticulocyte count on day 7 to 10 ✓
- B Rise in haemoglobin by 1 g/dL
- C Normalisation of serum ferritin
- D Correction of MCV to normal range
Correct answer: A. Peak reticulocyte count on day 7 to 10
Explanation
With effective oral iron, marrow erythroid hyperplasia produces a brisk reticulocyte response that peaks around day 7 to 10, confirming both the diagnosis of iron deficiency and adequate absorption before any measurable haemoglobin rise. Haemoglobin rises about 1 g/dL every 2 to 3 weeks thereafter, and MCV corrects only after several weeks. Ferritin normalises last, requiring continuation of iron for roughly 3 months after haemoglobin recovery.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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