In iron deficiency anemia, which red blood cell morphology reinforces the diagnosis?

• A. Schistocytes
• B. Hypochromic, microcytic red blood cells
• C. Macrocytic red blood cells
• D. Howell-Jolly bodies

Answer: (B)

In iron deficiency anemia, red blood cells show reduced hemoglobin content because iron is not available to form heme. This leads to smaller cells (microcytosis) with less hemoglobin per cell (hypochromia), so they appear pale with increased central pallor. This hypochromic, microcytic pattern is the hallmark morphology that strongly reinforces the diagnosis of IDA, especially alongside supportive labs like low ferritin and high TIBC.

Schistocytes are fragmented cells from intravascular hemolysis, not typical of iron deficiency. Macrocytic red cells point to B12 or folate deficiency (or other causes of macrocytosis). Howell-Jolly bodies are nuclear remnants seen with hyposplenism or post-splenectomy, not iron deficiency.