A 36-year-old man from China presents with increasing fatigue. He has a 3-year history of tuberculosis, and CBC shows a mild microcytic anemia. Blood work-up demonstrates low serum iron, low iron-binding capacity, and increased serum ferritin. The pathogenesis of anemia in this patient is most likely caused by which of the following mechanisms?
- History given in the question suggests the diagnosis of Anemia of chronic disease. - Chronic diseases leads to ineffective use of iron from macrophage stores in the bone marrow , resulting in functional iron deficiency, although storage iron is normal or even increased. - However, in contrast to iron deficiency anemia, total iron binding capacity tends to be decreased in this d/t decreased production of Transferrin. - All other choices are not related to anemia of chronic diseases. -->Causes of microcytic hypochromic anemia are: Sideroblastic anemia, Iron deficiency anemia, Thalassemia and Anemia of chronic diseases Blood work up done: a. Percentage of saturation and serum iron is decreased in iron deficiency anemia and anemia of chronic disease. b. Total iron binding capacity is increased in iron deficiency anemia. it is decreased in case of anemia of chronic disease 2. Biopsy can be done : a. Iron store are decreased /absent in iron deficiency anemia b. In Anemia of chronic disease, iron is present, but is restricted/ increased within macrophages
Clonal stem cell defect
Hypoxemia
Impaired utilization of iron from storage sites
Synthesis of structurally abnormal globin chains
Iron deficiency anemia