Anemia Of CD

Question 1

If an anemia occured in response to systemic illness or inflammation it’s called?

Answer 1

ACD

Question 2

What’s the pathophysiology of ACD

Answer 2

• lightly shortened RBC survival, thought to be due to release of inflammatory cytokines, occurs in patients with cancer or chronic granulomatous infections
• Erythropoiesis is impaired because of decreases in botherythropoietin(EPO) production and marrow responsiveness to EPO.
• Iron metabolism is altered due to an increase in hepcidin, which inhibits iron absorption and recycling, leading to iron sequestration

Question 3

What’s the typical Morphology of ACD

Answer 3

• normochromic or mildly hypo occurs in patients w systemic disease
• reduced serum iron and iron-binding capacity, and normal or raised serum ferritin with adequate iron stores

Question 4

Etiology of ACD, give example to each

Answer 4

• Chronic and acute viral, bacterial, parasitic or fungal infections
• Systemic connective tissue diseases, vasculitis and autoimmune disorders (rheumatoid arthritis, systemic lupus, IBD)
• chronic diseses (CKD,DM)
• alignancy

Question 5

How to diagnose Anemia of chronic disease

Answer 5

• Symptoms of the underlying disease
• Symptoms of the anemia
• The anemia is usually mild or moderate ( Hb 8-11g/dl) - lower values are observed in 20-30% of patients • The anemia is most often normochromic and normocytic, microcytic later on
• Erythrocyte sedimentation rate (ESR) - usually raised

Question 6

Whn orsein a lab for a patient with anemia caused by Cd what would u expect to find?

Answer 6

1. Serum Iron - decreased
2. TIBC Reduced
3. Transferrin saturation reduced
   Serum Ferritin-increased or normal
4. Serum Transferrin Receptor (sTR)-Normal
5. Sideroblasts in the bone marrow-reduced (5-20%)