Hemochromatosis commonly develops, and the major cause of death is cardiac failure due to myocardial siderosis by the end of the third decade. Unlike most hemolytic disease, the anemia is hypochromic and microcytic. This is probably due to the defect in hemoglobin synthesis. Extreme poikilocytosis with bizarre shapes, target cells, ovalocytosis, Cabot rings, Howell Jolly bodies, nuclear fragments, siderocytes, anisocytosis and often extreme normoblastosis are present. Normoblastosis is more severe after splenectomy.
Thalassemia minor is a heterozygous beta Thalassemia.
In many persons there is a mild hypochromic microcytic anemia, with slight jaundice and splenomegaly. Most individuals with Thalassemia minor however, have no symptoms or abnormal physical signs. Usually there is no anemia. RBC count is elevated, hemoglobin and hematocrit are reduced. The mean cell hemoglobin concentration is low but often normal.