Causes of microcytic anemia (MCV <80 fL)

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Causes of microcytic anemia (MCV <80 fL)

Common Rare

Hereditary Alpha thalassemia Other thalassemic variants (Hb E, Hb

Beta thalassemia Lepore)
X-linked and other sideroblastic
anemias
Hereditary hypotransferrinemia
Hereditary aceruloplasminemia
Erythropoietic protoporphyria
Iron-refractory iron deficiency
anemia
Pathogenic variants in SLC11A2

Acquired Iron deficiency Lead poisoning

ACD/AI* Zinc deficiency
Copper deficiency ¶
Alcohol Δ
Certain drugs

Refer to UpToDate for details of the evaluation and other rare causes of microcytic anemia.

MCV: mean corpuscular volume; Hb: hemoglobin; ACD/AI: anemia of chronic disease/anemia of
inflammation.

* ACD/AI often causes normocytic rather than microcytic anemia.

¶ Copper deficiency may be due to zinc toxicity.

Δ Excess alcohol use can cause multifactorial anemia from iron deficiency, folate deficiency, hemolysis,
and/or direct bone marrow suppression. The MCV may be low, normal, or high.

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Causes of microcytic anemia (MCV <80 fL)
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