Which labs indicate that your patient is anemic? Explain the significance of the following values: MCH, MCV, RDW, reticulocyte count, serum ferritin, TIBC, and serum iron. Explain the difference between iron deficiency anemia, thalassemia, and anemia of chronic disease. Briefly describe the treatment for one of these conditions.

Iron Deficiency Anemia Thalassemia and Anemia of Chronic Disease

Iron deficiency anemia (IDA) is described as a reduction in the number of red blood cells or hemoglobin in the blood caused by a drop in iron levels in the body. IDA can be due to blood loss (urinary tract bleeding, stomach ulcers, uterine fibroids), poor iron absorption due to gastrointestinal disorders such as celiac disease, or insufficient dietary intake. It is associated with low ferritin and a high total iron-binding capacity. Anemia of chronic disease is a functional anemia of iron-restricted erythropoiesis associated with conditions like end-organ failure, cancer, autoimmune diseases, and infections. This type of anemia can be microcytic but is mostly normocytic. It is associated with normal or elevated ferritin, reflecting that ferritin is produced as an acute phase reactant as iron is sequestered within cells. Total iron-binding capacity is either low or normal in anemia of chronic disease. Thalassemia is a diverse collection of blood disorders in which hemoglobin genes are disrupted, leading to impaired erythropoiesis. A peripheral blood smear shows hypochromic cells, microcytic cells, Heinz bodies, and anisocytosis (Tyas et al., 2020). Thalassemia presents with a decreased total iron-binding capacity and elevated ferritin levels. DNA analysis is done to confirm thalassemia.

Anemia of chronic disease is treated by addressing the underlying condition. Anemia typically improves or resolves entirely when the underlying condition is successfully treated. Direct treatment of anemia of chronic disease without addressing the underlying condition involves the administration of oral iron supplements or vitamins. However, such efforts have failed since they have a detrimental effect on the general health of patients. For instance, using iron supplements is debatable since certain infections and diseases like cancer require iron to grow and spread (Salnikow, 2021). Therefore, management of the underlying condition is the most preferred approach in the treatment of anemia of chronic disease.

References

Salnikow, K. (2021). Role of iron in cancer. Seminars in Cancer Biology, 76(xxxx), 189–194. https://doi.org/10.1016/j.semcancer.2021.04.001