In thalassemia trait, RBC count is typically what in relation to Hb?

• A. Mean corpuscular volume is normal
• B. Red blood cell count is normal or increased
• C. Hematocrit is reduced
• D. Platelet count is increased

Answer: (B)

Thalassemia trait shows microcytosis with an unexpected finding: red blood cell numbers stay normal or even rise despite the low hemoglobin. The bone marrow churns out more red cells to compensate for the reduced Hb production, so the RBC count is normal or increased even though each cell carries less hemoglobin. This contrasts with iron deficiency, where RBC count tends to be low and MCV is also reduced. Platelet counts are not a defining feature here, and hematocrit can be normal or only mildly reduced, but the standout pattern is the normal or elevated RBC count relative to Hb.