The determination in a 70-year-old woman of hematocrit 32%, Hb 9.6 g/dL, MCV 85 fL (70-99), Fe 25 ug/dL (37-145) and ferritin 350 ng/mL (15-150), is more suggestive of:
Polymyalgia rheumatica. Classic example I suppose, and it is seen in the clinic in droves. Older woman with normocitic anemia and clear ferrokinetic pattern of chronic disorder (hyposideremia but hyperferritinemia). The only one that fits, and it fits perfectly, is number 3; they only needed to give us a high ESR. 1: if it is a recent loss, the MCV could remain normal, but the ferritin should be affected, and certainly not elevated. 2: the same. If it is due to Fe malabsorption, ferritin should be low. And if it were due to B12 malabsorption, the MCV would be clearly higher. 4: 70 tachycardia and normal MCV. This one is too much.
Recent blood loss through the digestive tract.
Intestinal malabsorption.
Polymyalgia rheumatica.
Thalassemia minor.
1: if it is a recent loss, the MCV could remain normal, but the ferritin should be affected, and certainly not elevated.
2: the same. If it is due to Fe malabsorption, ferritin should be low. And if it were due to B12 malabsorption, the MCV would be clearly higher.
Older woman with normocitic anemia and clear ferrokinetic pattern of chronic disorder (hyposideremia but hyperferritinemia). The only one that fits, and it fits perfectly, is number 3;
4: 70 tachycardia and normal MCV. This one is too much.