Anemia of Chronic Disease: The Daily PANCE Blueprint

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Anemia of Chronic Disease: The Daily PANCE Blueprint

A 65-year-old man with a history of rheumatoid arthritis presents with fatigue and shortness of breath. He denies any blood loss, hematuria, or significant change in diet. On examination, he appears pale. Laboratory tests reveal a hemoglobin level of 10.5 g/dL, mean corpuscular volume (MCV) of 85 fL, ferritin level of 300 ng/mL, serum iron of 30 µg/dL, and total iron-binding capacity (TIBC) of 200 µg/dL. The peripheral blood smear shows normocytic, normochromic red blood cells without reticulocytosis. What is the most likely cause of his anemia?

A. Iron deficiency anemia
B. Anemia of chronic disease
C. Thalassemia minor
D. Sideroblastic anemia
E. Myelodysplastic syndrome

Answer and topic summary

The answer is B. Anemia of chronic disease

Anemia of chronic disease (ACD) is characterized by the presence of an underlying chronic inflammatory condition, such as rheumatoid arthritis, in this patient. Laboratory findings in ACD typically include low serum iron, low TIBC, and normal to increased ferritin levels, reflecting the sequestration of iron in the reticuloendothelial system and a decreased release of iron from macrophages. The peripheral blood smear often shows normocytic, normochromic red blood cells, as seen in this patient.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Hematology ⇒ Cytopenias (PEARLS) ⇒ Anemias (PEARLS) ⇒ Anemia of chronic disease

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