A 32-year-old woman comes to the physician because of a 6-week history of fatigue and weakness. Examination shows marked pallor of the conjunctivae. She has a history of systemic lupus erythematosus and is noncompliant with therapy. The remainder of the examination shows no abnormalities. Laboratory results are as follows: Which of the following is the most likely underlying cause of her current condition?

Question

A 32-year-old woman comes to the physician because of a 6-week history of fatigue and weakness. Examination shows marked pallor of the conjunctivae. She has a history of systemic lupus erythematosus and is noncompliant with therapy. The remainder of the examination shows no abnormalities.  Laboratory results are as follows:  Which of the following is the most likely underlying cause of her current condition?

Quizplus · Accepted Answer

Eductional Objective: Anemia of chronic disease is a consequence of chronically elevated inflammatory cytokines, most importantly hepcidin.  This peptide inactivates iron channels on enterocytes and reticuloendothelial macrophages, leading to reduced iron absorption and reduced iron release from the reticuloendothelial system.  The net result is normocytic or slightly microcytic anemia with low reticulocyte response, low serum iron level, and normal or low total iron-binding capacity.

A 32-Year-Old Woman Comes to the Physician Because of a 6-Week