Which condition can produce a normal MCV but lead to hypochromic RBCs on a peripheral blood smear?

A normal mean corpuscular volume (MCV) with hypochromic red blood cells (RBCs) in a peripheral blood smear indicates that while the size of the red blood cells remains normal, their hemoglobin content is reduced, causing a pale appearance. This situation is typically associated with conditions that affect hemoglobin synthesis rather than red blood cell production.

Hyperglycemia, while it can affect various metabolic processes and lead to changes in blood composition, does not specifically cause hypochromic red blood cells or affect hemoglobin content in the way that hematologic conditions do. Other conditions such as iron deficiency anemia are more commonly associated with both a hypochromic smear and microcytic anemia (low MCV).

In cases of iron deficiency anemia, RBCs often appear hypochromic because of insufficient iron leading to reduced hemoglobin synthesis. In vitamin B12 deficiency, one would expect to find macrocytic RBCs (high MCV) due to impaired DNA synthesis, not a normal MCV with hypochromic cells.

Therefore, while it may seem plausible, hyperglycemia does not align with the hematologic characteristics needed to produce normal MCV while displaying hypochromic RBCs. The understanding of hematologic