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* sideroblastic anemia help
 #562221  
  pursuit - 01/15/11 16:25
 
  Is Total iron binding capacity (TIBC):

1-Increased

2-Decreased

3-Normal

??

Thanks in advance for your help.
 
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* Re:sideroblastic anemia help
#2309342
  the_dumb - 01/15/11 18:05
 
  i mean ferritin is given normal,not increased so as to qualify for hemochromatosis or siderpblastic anemia in n choice C.  
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* Re:sideroblastic anemia help
#2309346
  the_dumb - 01/15/11 18:10
 
  E can be aplastic Anemia.
where we see following

Normal or high-serum Iron
S.ferritin-Increased
TIBC-Normal
Transferrin saturation-Increased
 
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* Re:sideroblastic anemia help
#2309348
  pursuit - 01/15/11 18:13
 
 
Choice A) is seen in anemia of chronic disease.

Choice B) is the normal condition.

Choice C) is seen in Sideroblastic anemia.

Choice D) is seen in iron def anemia

Choice E) is just a distracter.


According to UW, but I agree with you(the_dumb), TIBC is decreased to Normal in sideroblastic anemia but not increased!!!!

While reading genxraver-girl's notes, I found in page 45

" Sideroblastic anemia is characterized by increased serum iron levels and very low TIBC".

And then in page 48:

" Iron studies typically reveal increased serum iron concentration, increased total iron
binding capacity, which helps to differentiate sideroblastic anemia from iron deficiency
anemia.


I think again TIBC could decreased or Normal, so please check those notes from UW.

 
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* Re:sideroblastic anemia help
#2309349
  pursuit - 01/15/11 18:16
 
  A 60-year-old man comes to office with persistent complaints of malaise and easy
fatigability, for the past 8 months. On examination, he appears pale. PR: 93/min;
BP: 127/84mm Hg; Temperature: 37C(98.6F); RR:16/min. Fecal occult blood test
is negative. Further testing is ordered that include CBC, serum electrolytes and
colonoscopy. The results are:
RBC Indices were:

Serum Iron, Ferritin, TIBC, Transferrin Saturation
WBC 7,600mm3
Hemoglobin8.8 gm/dL
Hematocrit 30%,
RBC cont 3.6 million
Platelets 211,000mm3
MCV 65 fL
MCH 16.5 pg
MCHC 26%
Reticulocyte count0.5%
Which one of the following is expected on iron studies in this patient?
A. Low,High,Low,Low to normal
B. Normal,Normal,Normal,Normal
C. High,Normal,High,Normal to High
D. Low,Low,High,Low
E. Low,Low,Low,Low

Explanation:
The patient has microcytic hypochromic anemia due to chronic blood loss, which may not always be detected by FOBT. RBC indices reveal a decreased MCV, MCH, and a decreased reticulocyte count which correlates with Iron deficiency anemia. The peripheral blood picture of anisocytosis, microcytosis, hypochromia and poikilocytosis further confirms the diagnosis. Iron deficiency anemia results in decreased serum iron, ferritin, and percent saturation (Serum Iron / TIBC) along with an increased TIBC (Choice D).

(Choice A) is seen in anemia of chronic disease.

(Choice B) is the normal condition.

(Choice C) is seen in Sideroblastic anemia.

(Choice E) is just a distracter.

 
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* Re:sideroblastic anemia help
#2309351
  pursuit - 01/15/11 18:19
 
  Sorry it is mixed-up:(

A 60-year-old man comes to office with persistent complaints of malaise and easy fatigability, for the past 8 months. On examination, he appears pale. PR: 93/min; BP: 127/84mm Hg; Temperature: 37C(98.6F); RR:16/min. Fecal occult blood test is negative. Further testing is ordered that include CBC, serum electrolytes and colonoscopy. The results are:

WBC 7,600mm3
Hemoglobin8.8 gm/dL
Hematocrit 30%,
RBC cont 3.6 million
Platelets 211,000mm3

RBC Indices were:

MCV 65 fL
MCH 16.5 pg
MCHC 26%
Reticulocyte count0.5%

Which one of the following is expected on iron studies in this patient?

Serum Iron, Ferritin, TIBC, Transferrin Saturation
A. Low,High,Low,Low to normal
B. Normal,Normal,Normal,Normal
C. High,Normal,High,Normal to High
D. Low,Low,High,Low
E. Low,Low,Low,Low

Explanation:
The patient has microcytic hypochromic anemia due to chronic blood loss, which may not always be detected by FOBT. RBC indices reveal a decreased MCV, MCH, and a decreased reticulocyte count which correlates with Iron deficiency anemia. The peripheral blood picture of anisocytosis, microcytosis, hypochromia and poikilocytosis further confirms the diagnosis. Iron deficiency anemia results in decreased serum iron, ferritin, and percent saturation (Serum Iron / TIBC) along with an increased TIBC (Choice D).

(Choice A) is seen in anemia of chronic disease.

(Choice B) is the normal condition.

(Choice C) is seen in Sideroblastic anemia.

(Choice E) is just a distracter.
 
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* Re:sideroblastic anemia help
#2309352
  the_dumb - 01/15/11 18:21
 
  yes pursuit,TIBC is never increased in sideroblastic anemia,its always either normal or low and ferritin is also mostl high,but can be normal depend on the extent and cause of SA.what ab the one i ask in last post?  
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* Re:sideroblastic anemia help
#2309353
  pursuit - 01/15/11 18:25
 
  Normal or high-serum Iron
S.ferritin-Increased
TIBC-Normal
Transferrin saturation-Increased


hemochromatosis ???
 
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* Re:sideroblastic anemia help
#2309355
  the_dumb - 01/15/11 18:28
 
  In hemochromatosis,Serum Iron is never Normal,otherswise its not hemochromatosis,although others can match in hemochromatosis except Iron levels and TIBC here...its seen in Thalassemia.  
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* Re:sideroblastic anemia help
#2309358
  pursuit - 01/15/11 18:33
 
  okay Thanks The_dumb  
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* Re:sideroblastic anemia help
#2309359
  the_dumb - 01/15/11 18:33
 
  In thalassemia S.Fe and ferritin are towards high because of RBCs in peripheral smear due to increased erythropoeisis,but TIBC is not decreased or increased,its always normal.  
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