Anemia of Chronic Disease

Question 1

What acute phase reactant is seen in association with anemia of chronic disease?

Answer 1

Hepcidin

Question 2

What are the two mechanisms by which hepcidin sequesters iron in storage sites?

Answer 2

Limiting iron transfer from macrophages to erythroid precursors

Suppressing erythropoietin (EPO) production

Question 3

How does hepcidin released during a state of chronic inflammation lead to microcytic anemia?

Answer 3

Decreased available iron → decreased heme→ decreased Hb→ microcytic anemia

Question 4

With respect to ferritin, TIBC, Serum iron and % saturation of iron, what are the laboratory findings seen with anemia of chronic disease?

Answer 4

Ferritin—increased
TIBC—decreased
Serum iron—decreased
% saturation—decreased

Question 5

Why is there an increase in free erythrocyte protoporphyrin (FEP) in anemia of chronic disease?

Answer 5

There is a decreased amount of Fe→ decreased binding of protoporphyrin to Fe to form heme and increased free levels of protoporphyrin

Question 6

What is the treatment for anemia of chronic disease?

Answer 6

Treat the underlying cause—such as autoimmune disorder—or whatever is causing the chronic inflammatory state