If a patient of Asian or Mediterranean descent presents with microcytic anemia and normal iron studies, what is the next step in management?

When a patient of Asian or Mediterranean descent presents with microcytic anemia and normal iron studies, the most appropriate next step in management is to evaluate for alpha thalassemia minor through molecular genetic testing. This is particularly relevant given the demographic context, as individuals from these backgrounds are at a higher risk for thalassemias.

In cases of microcytic anemia, the most common etiology to consider is iron deficiency anemia; however, when iron studies are normal, other causes must be investigated. Alpha thalassemia minor can result in microcytic anemia without the accompanying iron deficiency findings. Genetic testing allows for confirmation of alpha thalassemia by identifying mutations in the alpha globin genes.

This targeted approach not only aids in establishing the correct diagnosis but also helps in guiding future management. For instance, if alpha thalassemia is confirmed, patients can be monitored without unnecessary iron supplementation, which would be contraindicated and potentially harmful if the anemia is not due to iron deficiency.

In contrast, the other options do not address the specific circumstances presented by this patient. While iron supplementation is commonly prescribed for iron deficiency anemia, it would not be correct in this instance since iron stores are normal. A bone marrow biopsy would be an unnecessary