Anemia of chronic disease: The Daily PANCE Blueprint

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Anemia of chronic disease: The Daily PANCE Blueprint

A 62-year-old man with longstanding osteoarthritis and chronic kidney disease presents with fatigue. He denies overt blood loss. Physical exam is unremarkable. His hemoglobin is 10.2 g/dL, and MCV is 88 fL. Serum iron studies are ordered. What pattern of lab findings is most consistent with anemia of chronic disease?

A. ↓Iron, ↑TIBC, ↓Ferritin
B. ↓Iron, ↓TIBC, ↑Ferritin
C. ↑Iron, ↓TIBC, ↑Ferritin
D. ↓Iron, ↑TIBC, ↑Ferritin
E. ↑Iron, ↑TIBC, ↓Ferritin

Answer and topic summary

The answer is B. ↓Iron, ↓TIBC, ↑Ferritin

Anemia of chronic disease (ACD), or anemia of inflammation, is typically a normocytic, normochromic anemia seen in chronic infections, inflammatory diseases, or malignancies. The hallmark laboratory findings are ↓serum iron, ↓total iron-binding capacity (TIBC) due to decreased transferrin production, and ↑ferritin as an acute-phase reactant. Despite low serum iron, ferritin remains normal or elevated, reflecting iron sequestration in macrophages and reduced iron availability to erythroid precursors. These values distinguish ACD from iron deficiency anemia, which typically shows ↑TIBC and ↓ferritin.

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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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