Lab values in anemia

Question 1

Iron deficiency anemia

• Serum iron
• Transferrin or TIBC
• Ferritin
• % transferrin saturation (serum iron/TIBC)

Answer 1

• Serum iron
  
  • ↓
• Transferrin or TIBC
  
  • ↑
• Ferritin
  
  • ↓
• % transferrin saturation (serum iron/TIBC)
  
  • ↓↓

Note:

• Transferrin – transports iron in blood
• TIBC – indirectly measures transferrin
• Ferritin – 1° iron storage protein of body
• ​Summary:*
• Only TT (transferrin and TIBC) increase in IDA

Question 2

Anemia of chronic disease

• Serum iron
• Transferrin or TIBC
• Ferritin
• % transferrin saturation (serum iron/TIBC)

Answer 2

• Serum iron
  
  • ↓
• Transferrin or TIBC
  
  • ↓
• Ferritin
  
  • ↑
• % transferrin saturation (serum iron/TIBC)
  
  • Normal

Note:

• Transferrin – transports iron in blood
• TIBC – indirectly measures transferrin
• Ferritin – 1° iron storage protein of body
• Evolutionary reasoning – pathogens use circulating iron to thrive; the body has adapted a system in which iron is stored within the cells of the body and prevents pathogens from acquiring circulating iron
• Summary:*
• In ACD, only ferritin increases!

Question 3

Hemochromatosis

• Serum iron
• Transferrin or TIBC
• Ferritin
• % transferrin saturation (serum iron/TIBC)

Answer 3

• Serum iron
  
  • ↑
• Transferrin or TIBC
  
  • ↓
• Ferritin
  
  • ↑
• % transferrin saturation (serum iron/TIBC)
  
  • ↑↑

Note:

• Transferrin – transports iron in blood
• TIBC – indirectly measures transferrin
• Ferritin – 1° iron storage protein of body

Memory aid:

• IDA has increased TT
• He has low TT

Question 4

Pregnancy/OCP use

• Serum iron
• Transferrin or TIBC
• Ferritin
• % transferrin saturation (serum iron/TIBC)

Answer 4

• Serum iron
  
  • Normal
• Transferrin or TIBC
  
  • ↑
• Ferritin
  
  • Normal
• % transferrin saturation (serum iron/TIBC)
  
  • ↓

Note:

• Transferrin – transports iron in blood
• TIBC – indirectly measures transferrin
• Ferritin – 1° iron storage protein of body

Question 5

What is the role of ferritin in the body?

Answer 5

It is the primary iron storage protein of the body

Question 6

What is the relationship between transferrin and total iron-binding capacity?

Answer 6

Total iron-binding capacity is an indirect measure of transferrin, which transports iron in the blood

Memory aid:

• _Trans_ferrin
• _Trans_ports

Question 7

What is the evolutionary theory behind the etiology of anemia of chronic disease?

Answer 7

Pathogens need iron to thrive; sequestration of iron in macrophages may prevent pathogens from reproducing