Your patient is a 30-year-old female with microcytic anemia. What lab result is not expected in her case?

In the case of microcytic anemia, especially related to iron deficiency, certain laboratory findings are characteristic. One of the expected results is an increased Total Iron Binding Capacity (TIBC) due to the body's compensatory mechanisms in response to low iron stores.

In this patient's scenario, a TIBC of 300 is indeed not expected. Typically, TIBC is elevated in cases of iron deficiency anemia, meaning that the body is trying to maximize the amount of iron it can bind and transport. Thus, a TIBC of 300 would suggest a normal or low binding capacity, which is atypical for microcytic anemia associated with iron deficiency.

In contrast, low serum ferritin is expected because ferritin reflects the stored iron in the body, and in iron deficiency anemia, these stores are depleted. Low hemoglobin is also a common finding since anemia involves reduced hemoglobin levels, leading to symptoms of fatigue and weakness. Additionally, mean cell hemoglobin concentration (MCHC) being less than 32% is aligned with microcytic anemia, where the red blood cells are smaller and have less hemoglobin concentration compared to normal.

Therefore, TIBC of 300 is not consistent with the expectations surrounding microcytic anemia, marking it as