Question

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?

Answer 1

1). It is given that Jose is experiencing the recurrent urinary tract bleeding. Means, he might have been using the antimicrobial therapy repeatedly and experiencing loss of blood through the urinary tract. This would negatively affect his hematopoietic system, the antimicrobial drugs reduce the production the blood cells from the bone marrow and also sensitize the white blood cells in the periphery. Frequent loss of blood also reduces the red blood cell count, white blood cell count, and the platelet count, Overall, these conditions lead to anemia.