Severe Hypochromic Microcytic Anemia in Blood Smear

A clinical case of severe anemia (Hb 44 g/L) featuring microcytosis, anulocytes, dacryocytes, poikilocytosis, reactive thrombocytosis, and analyzer printout.

Olga Vakhlaeva 1 min November 22, 2025

Blood smear: marked hypochromia, anulocytes, poikilocytosis, and anisocytosis

Blood smear: microcytes, poikilocytes, and thrombocytosis in the field of view

Blood smear: segmented neutrophil among hypochromic microcytes

Blood smear: ring-shaped erythrocytes (anulocytes) and a dacryocyte

Analyzer printout: HGB 44 g/L, MCV 59.4 fL, hypochromia, and thrombocytosis

Patient: 70-year-old female. Peripheral blood picture:

Severe anemia: hemoglobin 44 g/L. Erythrocytes are hypochromic, microcytic, with marked anisocytosis, aniso-chromia, and poikilocytosis.
The smear predominantly shows anulocytes (ring-shaped erythrocytes); echinocytes, dacryocytes, and leptocytes (target cells) are also noted.
Normoblasts: Found in a quantity of 2 per 100 leukocytes.
Thrombocytosis.

🙏 The publication was kindly provided by Olga Vakhlaeva, Biologist at SBEI ACCH, Alchevsk, LPR