USMLE Step 1 Question of the Day
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A 40 year old female with SLE complains of increasing fatigue over the past several months. On exam she is found to have a Hb of 9.3g/dl. A blood smear is obtained and shows normochromic normocytic erythrocytes. An iron panel is obtained with the following values:
Iron: 43
TIBC: 212
Ferritin: 368What is likely cause for her anemia?
Correct Answer: A. Anemia of chronic disease
In anemia of chronic disease (option A), patients will have normochromic normocytic anemia with low iron, low TIBC and high ferritin. Anemia of chronic disease often accompanies chronic diseases like SLE, Crohn’s disease, rheumatoid arthritis.
In comparison to iron deficiency anemia (option D) which is a hypochromic, microcytic anemia in which the iron is low, the TIBC is high and ferritin is low.
Folate and B12 deficiency are macrocytic in nature often with hypersegmented neutrophils. Lead poisoning is also normocytic however, basophilic stipling will usually be seen on a smear as well.
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Category: PathophysiologyA 40 year old female with SLE complains of increasing fatigue over the past several months. On exam she is found to have a Hb of 9.3g/dl. A blood smear is obtained and shows normochromic normocytic erythrocytes. An iron panel is obtained with the following values:
Iron: 43
TIBC: 212
Ferritin: 368What is likely cause for her anemia?
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