A 52-year-old African American man comes to the physician for the evaluation of worsening fatigue that started 1 year ago. He does not have chest pain or shortness of breath. Medical history is significant for hypertension and obesity. BMI is 45 kg/m². Examination shows mild mucosal pallor. Laboratory results are as follows: Which of the following is the most likely cause of this patient's anemia?

Question

Quizplus · Accepted Answer

Eductional Objective: Anemia of chronic disease (ACD) occurs in patients with rheumatologic diseases, chronic infection, malignancy, congestive heart failure, and morbid obesity due to chronic elevation of inflammatory cytokines.  The primary mediator is hepcidin, a peptide released from the liver that inhibits iron channels on enterocytes and reticuloendothelial macrophages.  This reduces iron availability for erythropoiesis, which leads to normocytic (or slightly microcytic) anemia with a poor reticulocyte response.

A 52-Year-Old African American Man Comes to the Physician for the Evaluation