Anemia Table

Question 1

Table

Answer 1

Question 2

What are the iron study findings in iron deficiency anemia?

Answer 2

↓ MCV, ↓ MCHC, ↓ sFe, ↓ ferritin, ↑ transferrin, ↓ transferrin saturation (<20%), ↑ TIBC

Question 3

What are the iron study findings in anemia of chronic disease (inflammation)?

Answer 3

↓/N MCV, ↓ MCHC, ↓ sFe, N ferritin, ↓ transferrin, ↓ transferrin saturation, ↓/N TIBC

Question 4

What are the iron study findings in acute phase response?

Answer 4

N MCV, N MCHC, ↓ sFe, ↑ ferritin (*note: ferritin is highly variable), ↓ transferrin, ↓ transferrin saturation, ↓ TIBC

Question 5

What are the iron study findings in iron overload?

Answer 5

N MCV, N MCHC, ↑ sFe, ↑ ferritin, N transferrin, ↑ transferrin saturation, ↑ TIBC

Question 6

What is the mechanism of anemia of chronic inflammation

Answer 6

Mechanism of Anemia of Chronic Disease

🔹 Decreased Iron Availability
* Inflammatory cytokines → ↑ hepcidin synthesis.
* Hepcidin inhibits iron release → “iron trapping” in marrow & macrophages.
* Iron stores are normal, but circulating iron is ↓.
* Result: functional iron deficiency → ↓ erythropoiesis.

🔹 Increased Erythrocyte Phagocytosis
* Cytokine-activated macrophages destroy RBCs prematurely.
* Shortened red cell lifespan contributes to anemia.

🔹 Decreased Erythropoiesis
* Cytokines directly suppress erythropoiesis in bone marrow.
* May also suppress renal erythropoietin production.

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Question 7

Management of Anemia of chronic inflammation

Answer 7

Management
* Treat underlying inflammation.
* Red cell transfusion if required.
* Iron infusions usually ineffective (iron stores are normal).
* Erythropoietin (EPO) not routinely beneficial.