Typical causes of<unk>  include: * Childhood * Iron deficiency<unk> , by far the most common cause of<unk>  in general and of<unk>  in particular * Thalassemia * Sideroblastic<unk> . Very rare. In congenital sideroblastic<unk>  the MCV (mean corpuscular volume) is either low or normal. In contrast, the MCV is usually high in the much more common acquired sideroblastic<unk> . * Adulthood * Iron deficiency<unk>  * Thalassemia *<unk>  of chronic disease, (aso known as<unk>  of inflammation) although this can also be normocytic.<unk>  has been discussed by Weng et al. * Lead poisoning – very rare. * Hyperthyroidism – very rare. * Vitamin B6 (pyridoxine) deficiency – very rare. Other causes that are typically thought of as causing normocytic<unk>  or<unk>  must also be considered, and the presence of two or more causes of<unk>  can distort the typical picture. There are five main causes of<unk>  forming the acronym TAILS. Thalassemia,<unk>  of chronic disease, iron deficiency, lead poisoning and congenital sideroblastic<unk> . Only the first three are common in most parts of the world. In theory, these three can be differentiated by their red blood cell (RBC) morphologies.<unk>  of chronic disease shows unremarkable RBCs, iron deficiency shows anisocytosis, anisochromia and elliptocytosis, and thalassemias demonstrate target cells and coarse basophilic stippling. In practice though elliptocytes and anisocytosis are often seen in thalassemia and target cells occasionally in iron deficiency. All three may show unremarkable RBC morphology. Basophilic stippling is one morphologic finding of thalassemia which does not appear in iron deficiency or<unk>  of chronic disease. The patient should be in an ethnically at risk group and the diagnosis is not confirmed without a confirmatory method such as hemoglobin HPLC, H body staining, molecular testing or another reliable method. Coarse basophilic stippling occurs in other cases as seen in Table 1.
Microcytic anemia
Macrocytic anemia
Lycopenemia
Hypochromic anemia
Reticulocytosis
Normochromic anemia
Osteopenia
Microhematuria