In alpha thalassemia minor, anemia is mild to absent. The red blood cell count increases, while the hemoglobin decreases slightly. The MCV and MCHC are slightly decreased. The RDW is normal to slightly increased. Red blood cell morphology shows slight hypochromic microcytosis. Reticulocytes are normal to slightly increased.
Hemoglobin electrophoresis demonstrates a normal pattern in adults:
- Hb A - 95–98%
- Hb A2 - 1.5–3.7%
- Hb F - <2%
Note: Neonates have 5–15% Bart's Hemoglobin (gamma chain tetramers). Hb H inclusions are rarely seen. Bone marrow demonstrates erythroid hyperplasia.
