Mehlman High Yield Practice Exam

In anemia of chronic disease, which statement about iron is most accurate?

Serum iron is high Serum iron is low Serum iron is normal Serum iron is variable

Correct Answer:

Serum iron is low

Explanation:

In anemia of chronic disease, inflammation drives iron into storage and out of circulation. Inflammatory signals stimulate the liver to produce hepcidin, a hormone that blocks ferroportin, the iron-exporting protein on gut cells and macrophages. When ferroportin is inhibited, iron can’t leave stores or be released into the bloodstream, so the circulating serum iron falls even though body iron stores (ferritin) may be normal or elevated. This sequestration also leads to lower transferrin saturation and a reduced ability to mobilize iron for red blood cell production. So the most accurate statement is that serum iron is low, reflecting iron being held in storage rather than shortage of total body iron.

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