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What is the primary definition of anemia of chronic disorders (ACD)?
ACD is a type of anemia that occurs in patients with chronic inflammatory or malignant diseases.
Enumerate two infectious and two non-infectious causes of ACD.
Infectious causes include tuberculosis and pneumonia; non-infectious causes include rheumatoid arthritis and systemic lupus erythematosus.
Explain the role of serum hepcidin in the pathogenesis of ACD.
Serum hepcidin inhibits the release of iron from macrophages and intestinal epithelial cells, affecting iron metabolism.
How do ESR and CRP levels typically respond in patients with ACD?
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What hematological complications could accompany ACD in patients with chronic diseases?
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Mention two malignant diseases that can lead to ACD.
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What is the effect of raised hepcidin levels on iron absorption?
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Define chronic renal failure's contribution to ACD.
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What laboratory investigation is essential for differentiating ACD from other anemias?
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Contrast the underlying mechanisms of iron deficiency anemia with ACD.
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What is a key factor influencing the pathogenesis of anemia of chronic disorders?
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Identify one chronic inflammatory disease that can lead to ACD.
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Describe the relationship between ESR and CRP in patients with ACD.
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Which type of anemia can complicate ACD due to chronic diseases?
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Name a hematological finding associated with ACD.
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What effect does hepcidin have on intestinal iron absorption in ACD?
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What role does chronic liver disease play in ACD?
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Which laboratory investigation is necessary to differentiate ACD from other types of anemia?
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Explain why hepcidin levels are elevated in ACD.
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What is the significance of ESR in the context of ACD?
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What is the impact of chronic inflammation on hepcidin levels?
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How do chronic diseases complicate the diagnosis of ACD?
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Discuss the role of macrophages in the pathogenesis of ACD.
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What differentiates ACD from iron deficiency anemia?
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Explain the relevance of CRP levels in ACD.
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What are the laboratory findings indicative of ACD?
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Identify the mechanisms through which chronic renal failure contributes to ACD.
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How do the ESR and CRP levels compare in patients with ACD?
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What is the significance of differential diagnosis in ACD treatment?
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What hematological changes might co-occur with ACD?
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Study Notes
Anemia of Chronic Disorders (ACD)
- ACD is a common anemia found in patients with chronic inflammatory and malignant diseases.
- Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are present in most cases.
- ACD can be complicated by additional hematological changes, such as iron or folate deficiencies, bone marrow infiltration, hypersplenism, or endocrine abnormalities.
Causes of ACD
- Infectious Diseases: Pulmonary abscess, tuberculosis, osteomyelitis, pneumonia, bacterial endocarditis, viral and parasitic infections.
- Non-Infectious Diseases: Rheumatoid arthritis, systemic lupus erythematosus, connective tissue diseases, sarcoidosis, Crohn's disease, and liver cirrhosis.
- Malignant Diseases: Carcinoma, lymphoma, sarcoma, myeloma.
- Chronic Renal Failure.
- Chronic Liver Diseases.
Pathogenesis of ACD:
- Hepcidin: A polypeptide produced by the liver, acts as the major regulator of iron homeostasis.
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Hepcidin Function:
- Inhibits iron release from macrophages and intestinal epithelial cells.
- Interacts with ferroportin, an iron exporter.
- Accelerates the degradation of ferroportin mRNA.
- Raised Hepcidin Levels: Profoundly affect iron metabolism by reducing iron absorption and release from macrophages.
Definition and Causes
- Anemia of chronic disorders (ACD) is a common anemia seen in patients with systemic disorders, particularly chronic inflammatory and malignant diseases.
- ACD is often associated with elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
- Causes of ACD include:
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Chronic inflammatory diseases:
- Infectious: Pulmonary abscess, tuberculosis, osteomyelitis, pneumonia, bacterial endocarditis, and some viral and parasitic infections.
- Non-infectious: Rheumatoid arthritis, systemic lupus erythematosus, other connective tissue diseases, sarcoidosis, Crohn's disease, and liver cirrhosis.
- Malignant diseases: Carcinoma, lymphoma, sarcoma, and myeloma.
- Chronic renal failure.
- Chronic liver diseases.
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Chronic inflammatory diseases:
Pathogenesis
- Hepcidin: A polypeptide produced by the liver, hepcidin plays a key role in regulating iron homeostasis.
- Iron regulation: Hepcidin inhibits iron release from macrophages and intestinal epithelial cells by interacting with ferroportin, a transmembrane iron exporter. It also accelerates the degradation of ferroportin mRNA.
- Impact on iron metabolism: Elevated hepcidin levels significantly affect iron metabolism by reducing iron absorption and release from macrophages, contributing to the development of ACD.
Anemia of Chronic Disorders (ACD)
- ACD commonly occurs in patients with chronic inflammatory and malignant diseases
- ACD is characterized by reduced red blood cell production
- ACD often presents alongside other hematological changes related to the underlying disease
Causes of ACD
-
Chronic inflammatory diseases:
- Infectious (e.g., pulmonary abscess, tuberculosis, osteomyelitis, pneumonia, bacterial endocarditis, viral and parasitic infections)
- Non-infectious (e.g., rheumatoid arthritis, systemic lupus erythematosus, other connective tissue diseases, sarcoidosis, Crohn's disease, liver cirrhosis)
-
Malignant diseases:
- Carcinoma, lymphoma, sarcoma, myeloma
- Chronic renal failure
- Chronic liver diseases
Pathogenesis
- Elevated serum hepcidin levels play a central role in ACD development.
- Hepcidin, a liver-produced polypeptide, is a key regulator of iron homeostasis.
- Hepcidin inhibits iron release from macrophages and intestinal epithelial cells.
- Hepcidin binds to ferroportin, a transmembrane iron exporter, leading to its degradation.
- This process reduces both iron absorption from the gut and iron release from macrophages.
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Description
This quiz covers the key aspects of Anemia of Chronic Disorders (ACD), including its causes, pathogenesis, and associations with chronic diseases. Participants will learn about the role of hepcidin and various infectious and non-infectious diseases linked to ACD. Prepare to test your knowledge on this important topic in hematology.