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?