Laboratory diagnosis

• Peripheral blood—normocytic/macrocytic RBC with anisopoikilocytosis.

• WBC and platelets usually normal; reticulocytes slightly 4.

• BM appearance—striking, showing 4 cellularity with excess abnormal erythroblasts.

• Type II shows positive acidified serum test.

• 4 Serum ferritin due to 4 Fe absorption; haemosiderosis can occur without transfusion dependence. Type III very occasionally Fe deficient due to intravascular haemolysis and haemosiderinuria.

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