Identify Prussian blue iron stain results in the following disorders and explain your answers:
a. Iron-deficiency anemia
b. Anemia of chronic disease
c. Thalassemia
d. Sideroblastic anemia
What will be an ideal response?
Answer:
Iron-deficiency anemia: decreased; the etiology of IDA is such that when a patient's iron need exceeds intake, the body utilizes its iron stores and decreases them; is often one of the first signs of iron-deficiency anemia
Anemia of chronic disease: adequate to increased; the problem is impaired ferrokinetics. There is adequate intake of iron but poor utilization of it. The primary protein abnormality that is responsible for this abnormal utilization is hepcidin. Hepcidin is produced in response to inflammatory cytokines, which are increased in patients with ACD, so the disorder often arises from an exacerbated inflammatory response.
Thalassemia: adequate to increased; the defect is improper globin chain synthesis, not iron usage.
Sideroblastic anemia: increased; this is the opposite of IDA. Iron intake exceeds the body's need for iron and can be improperly utilized.
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