A 30-year-old pregnant woman is found to have haemoglobin of 8.2 g/dL at 28 weeks with a peripheral smear showing microcytic hypochromic cells and target cells, serum ferritin 85 µg/L. The MOST likely diagnosis is:

• A Beta-thalassaemia trait ✓
• B Iron deficiency anaemia
• C Haemoglobin E trait
• D Anaemia of chronic disease

Explanation

The combination of microcytic hypochromic anaemia with target cells and a normal or elevated serum ferritin (85 µg/L, which is within or above normal range) indicates a haemoglobin disorder rather than iron deficiency. Iron deficiency would show low ferritin. The target cells and microcytosis with preserved iron stores in a 30-year-old Indian woman is most consistent with beta-thalassaemia trait. Haemoglobin electrophoresis showing elevated HbA2 (>3.5%) would confirm the diagnosis.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.