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* Anemia of Chronic Disease
 #700629  
  usmletime - 09/30/12 02:09
 
  Can someone please help explain the Iron panel in Anemia of Chronic Disease?

Iron: Decreased
TIBC: ?
Ferritin: Increased
Transferrin Saturation: ?
 
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* Re:Anemia of Chronic Disease
#2743121
  zen786 - 09/30/12 03:23
 
  anemia of chronic disease is due to INCREASE HEPCIDIN
which causes "SEQUESTRATION of IRON RELEASE"

with that in mind.

Serum Iron : decreased
TIBC: decreased [because this is inverse of ferritin]
ferritin [stored] : INCREASE
transferring saturation: decrease
Free erythrocyte protoporphoryin : INCREASE

okay ill explain each in simple ways now:

1: step of iron absorption then finally 3: the mechanism of the pathology

so iron is taken in dietary form [plants Fe3+ form, meat products Fe2+ form of which Fe2+ is easily absorbed]. This requires gastric acid from the stomach to keep iron in Fe2+ state. now once the iron from the stomach reaches the small intestine [specifically deuodunum] it requires enterocytes of the deuodunum to absorb iron through the "FERROPORTIN" [channel].
now once the iron is in the blood [basolateral side] it gets binded to transferrin for circulation. the transferrin takes the bound iron to its storage site [liver, and bone marrow macrophages]. the iron then is released from transferrin and bound to ferritin [ this is because Iron can cause free radical damage so to prevent this it stays bound to ferritin in Fe2+ stage] and its stored.


now step 2:

in anemia of chronic disease hepcidin prevents the release of IRON from stored site.

so what does that do the to the circulation IRON?? well obviously ** DECREASE **

what does that do to TIBC [aka transferrin] ?? well no circulating iron so ** DECREASE **

what does that do to stored iron [ferritin]?? ** INCREASE ** cause its preventing the release

what does that do to saturation of TIBC [transferrin] ?? ** DECREASE **

Free erythocyte protoporphyin basically increase because no IRON is available in serum where the reaction of protoporhyin + iron via ferrochelatase can occur to form HEME ..

i hope this helped... if any further clarification on a specific lab value please let me know

:) goodluck !
 
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* Re:Anemia of Chronic Disease
#2743129
  sujithanimg - 09/30/12 04:57
 
  thanks a lot a zen,,,,,,,,,,  
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* Re:Anemia of Chronic Disease
#2743149
  lipoma - 09/30/12 08:14
 
  chronic inflammmation ---so infections with bacteria --body wants to keep iron away from bugs and store it in BM macrophages and forget the key , so even if u want to take it out u cannot thus ferritin is increased.so body has the capacity to make more iron but don,t want to do that to prevent bactrial growth . this occurs in any chronic inflammation or any malignancy.
Mutation of Hamp gene that encodes for hepcidin causes juvenile haemachromatosis.
Hepcidin is increased in beta thalassemias and ch renal failure
just want to add a few points
 
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* Re:Anemia of Chronic Disease
#2745976
  usmletime - 10/03/12 18:14
 
  Thanks so much zen!  
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