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Microcytosis suggests a chronic process. In conjuction with a Menstzer index of > 13 ( MCV/RBC count in millions/cubic mm) it strongly suggests iron deficiency anemia. Acute infections indeed affect hemoglobin, but this is generally a normocytic process.

 These cases of occult or overt anemia detected incidentally on a hemogram deserve a follow up. The ED however is not the ideal setting to be working up chronic processes.   

Jay 
Jay Pershad, MD, FAAP
Asst. Professor
Division of Pediatric Emergency Medicine
UT College  of Medicine  
LeBonheur Children's Medical Center
Memphis, TN 38103
Pediatric Emergency Specialists, PC 

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