August 17, 2015 - Anemia of Chronic Disease

Question 1

Anemia of Chronic Disease

Answer 1

Also known as anemia of inflammation.

Normocytic, normochromic anemia. Association with inflammatory diseases, malignancy, infections, and chronic medical illness.

Not a problem with iron absorption, but a problem with the distribution of iron in the body.

Question 2

Erythropoietin

Answer 2

Is a glycoprotein hormone that controls erythropoiesis, or red blood cell production. It is a cytokine for erythrocyte precursors in the bone marrow.

Produced in the kidney in response to hypoxia.

Question 3

Hepcidin

Answer 3

An acute phase reactant produced by the liver in response to cytokines.

A protein that is a key regulator of the entry of iron into the circulation. In states in which the hepcidin level is abnormally high (such as inflammation), serum iron falls due to iron trapping within macrophages.

Question 4

Reticulocyte Count

Answer 4

A very important test to order when assessing for anemia of chronic disease. With a low amount of hemoglobin, you would expect the reticulocyte count to be elevated. If it is not elevated, then there lies a problem with the production of red blood cells.

Ferritin levels may also be high.

Question 5

Expected Lab Results - Fe Deficiency

Answer 5

Fe: low

TIBC: high

Ferritin: low

Question 6

Expected Lab Results - Normal

Answer 6

Fe: normal

TIBC: normal

Ferritin: normal

Question 7

Expected Lab Results - ACD

Answer 7

Fe: low

TIBC: low

Ferritin: high

Question 8

Androgens and RBC Production

Answer 8

Androgens increase RBC production.

Question 9

Estrogens and RBC Production

Answer 9

Estrogens decrease RBC production.

Women typically have fewer RBC than men.

Question 10

Anemia of Pregnancy

Answer 10

1. Physiologic (diluted by volume)
2. Iron deficiency
3. Folic acid deficiency

(2 and 3 are correctable through multivitamins)