How do the patient’s iron study results help in differentiating the diagnosis of iron deficiency from ACD?

An 83-year-old anemic male, Jose

Admitted to a local hospital

Recurrent urinary tract bleeding

Infection associated with prostatitis

Question 1: How can these conditions affect the hematopoietic system?

Jose’s CBC upon admission

RBC: 4.15 × 1012/L

Hb: 81 g/L

Hct: 0.26 L/L

Platelet: 174 × 109/L

WBC: 2.8 × 109/L

Question 2: How would you describe his anemia morphologically?

Reflex testing for anemia on Jose followed based on the CBC results.

Reticulocyte count: 2.6%

Serum iron: 18 mcg/dL

TIBC: 425 mcg/dL

Question 3: Calculate % saturation.

Question 4: Is this value normal, decreased, or increased?

Question 5: What disease, if any, does this value suggest?

Question 6: How do the patient’s iron study results help in differentiating the diagnosis of iron deficiency from ACD?

Question 7: What additional test that was not done would be most helpful in this case?

Question 8: Do the iron studies in Jose (serum iron 18 mcg/dL, TIBC 425 mcg/dL) suggest sideroblastic anemia? Why or why not?

Question 9: Based on the reticulocyte count, is his bone marrow having an adequate response to the marrow, why or why not?

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