Match each set of laboratory findings with the most likely hematologic diagnosis.
- Iron deficiency anemiaFerritin 12 ng/mL, TIBC 480 mcg/dL, Serum iron 25 mcg/dL, MCV 72 fL
- Anemia of chronic diseaseFerritin 550 ng/mL, TIBC 210 mcg/dL, Serum iron 40 mcg/dL, MCV 84 fL
- Thalassemia minorFerritin 150 ng/mL, TIBC 300 mcg/dL, Serum iron 95 mcg/dL, MCV 64 fL
- Sideroblastic anemiaFerritin 420 ng/mL, TIBC 280 mcg/dL, Serum iron 190 mcg/dL, MCV 70 fL
Cevap
Iron deficiency anemia matches with low ferritin and high TIBC. Anemia of chronic disease matches with high ferritin and low TIBC. Thalassemia minor matches with normal iron studies and severe microcytosis. Sideroblastic anemia matches with high ferritin and high serum iron.
The matching relies on foundational principles of iron metabolism and erythropoiesis. Iron deficiency anemia represents true total-body iron depletion, characterized by low ferritin and an appropriate compensatory increase in TIBC. Anemia of chronic disease is driven by inflammation-induced hepcidin release, which traps iron within cells (elevated ferritin) and suppresses transferrin (low TIBC). Thalassemia minor represents a structural globin synthesis defect, yielding profound microcytosis while leaving iron kinetics unperturbed. Lastly, sideroblastic anemia stems from impaired protoporphyrin synthesis, causing an inability to utilize iron and resulting in subsequent iron overload (elevated ferritin and serum iron) alongside microcytosis.
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Anahtar Kavram
Differential diagnosis of microcytic and normocytic anemias using iron studies