Lecture notes:
Renal failure –> increased Cr, Hb low, Hct low, MCV normal, ferritin normal, iron low, transferrin saturation normal –> anemia of chronic disease (AoCD)
Can be due any type of chronic disease, e.g., RA, SLE, IBD; can also be due to chronic infections like HepC.
Can treat with EPO is renal failure is etiology; if not renal failure, CANNOT give EPO and you treat underlying condition.
AoCD is usually normal MCV (80-100), but some 2CK Qs are presenting with low MCV; but if this is the case, you’d easily be able to eliminate the other answer choices in the Q.
For instance, if Q is presentation with a kid who has obvious JRA (Still disease) – salmon rash (about half the time), high ESR, recurrent joint pain – and MCV is, e.g., 72, answer is still AoCD if anemia is present.
Transferrin saturation = Fe / TIBC (total iron binding capacity)
Anemia of chronic disease: iron is low; ferritin is normal or even elevated; transferrin low; transferrin saturation low or normal (bc TIBC is low, bc transferrin low)
Iron deficiency: iron low; ferritin low; transferrin high; transferrin saturation super low (bc TIBC very high, since transferrin high)
