anemia of chronic disease (anemia of chronic inflammatory disease)

Question 1

lab features

Answer 1

• low serum iron
• normal or slightly low Tf sat
• increased ferritin
• normal or low sTfR

Question 2

basic mechanism

Answer 2

Inflammation stimulates IL-6 production –> IL-6 promotes hepatic hepcidin expression –> iron recycling becomes inefficient and iron is retained in macrophages –> transferrin saturation decreases –> erythropoiesis becomes iron restricted (iron is inaccessible for eyrthropoeisis) (cytokines also suppress erythropoiesis) –> if inflammatory state is prolonged, anemia ensues

Question 3

Iron deficiency in anemia of chronic disease?

Answer 3

Some patients eventually become truly iron-deficient if inflammation is prolonged due to decreased intestinal iron absorption