Test Specimen Diagnostic clue Mechanism
HB Whole blood Decreased Microcytic and hemolytic anemia(5)
MCV Whole blood Decreased Iron incorporation into heme is impaired(5)
MCH Whole blood Decreased Iron incorporation into heme is impaired(5)
PBS Whole blood Coarse basophilic stippling - Cabot rings Instability of RNA and remaining microtubules respectively, due to abnormal erythropoiesis(5)
Retic count Whole blood Increased Hemolytic anemia due to inhibition of Na-k dependent ATPases in cell membranes and increased fragility(8)
BM iron stain BM aspiration smear Ring sideroblast Iron accumulation in the mitochondria(8)
Blood lead level Whole blood Increased *
zinc-protoporphyrin Whole blood Increased zinc-protoporphyrin is formed instead of heme(8)
free red cell protoporphyrin Whole blood Increased It’s a product of zinc-protoporphyrin(8)
LDH Serum/Plasma Increased Hemolytic anemia(10)
Liver enzymes Serum/Plasma Increased Increasing oxidative stress (11)
BUN / Cr Serum/Plasma Increased Proximal tubular dysfunction and Fanconi-type syndrome(12)
Urine glucose Urine Increased (positive) Proximal tubular dysfunction and Fanconi-type syndrome(12)