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Samwel Mikaye: Understanding the Distinction Between Iron Deficiency Anemia and Anemia of Chronic Disease
Dr. S.0 MIKAYE / LinkedIn
May 5, 2026, 10:58

Samwel Mikaye: Understanding the Distinction Between Iron Deficiency Anemia and Anemia of Chronic Disease

Samwel Mikaye, Medical Doctor at MSK, shared a post on LinkedIn:

“Iron deficiency anemia

Definition

Anemia caused by true depletion of body iron stores, leading to reduced hemoglobin synthesis.

Causes:

  • Chronic blood loss (most common)
  • Menorrhagia
  • GI bleeding (ulcer, malignancy)
  • Poor dietary intake
  • Malabsorption (e.g., celiac disease)
  • Increased demand (pregnancy, growth)

Pathophysiology:

Reduced iron stores leads to reduced hemoglobin, which causes microcytic, hypochromic RBCs.

Clinical Features:

  • Fatigue, weakness
  • Pallor
  • Pica (ice/clay craving)
  • Koilonychia (spoon nails)
  • Glossitis, angular cheilitis

Lab Findings:

  • Reduced Hb
  • Reduced MCV
  • Reduced ferritin (KEY finding)
  • Increased TIBC
  • Reduced transferrin saturation

Management:

  • Treat cause (e.g., GI bleed workup)
  • Oral iron (ferrous sulfate)
  • IV iron if needed

Anemia of chronic disease

Definition:

Anemia caused by chronic inflammation/infection/malignancy leading to impaired iron utilization.

Causes:

  • Chronic infections (e.g., TB)
  • Autoimmune disease (RA, SLE)
  • Chronic kidney disease
  • Malignancy

Pathophysiology (key idea):

Inflammation upregulates hepcidin, which leads to iron trapped in macrophages
So iron is present but not usable.

Clinical Features:

  • Symptoms of underlying chronic disease
  • Mild anemia (usually less severe than iron deficiency)

Lab Findings:

  • Reduced or normal serum iron
  • Normal or increased ferritin (iron stored but trapped)
  • Reduced TIBC
  • Normal or slightly reduced MCV (can be normocytic or mildly microcytic)

Management:

  • Treat underlying disease
  • Erythropoietin (especially in CKD)
  • Iron therapy usually not effective alone.”

Samwel Mikaye: Understanding the Distinction Between Iron Deficiency Anemia and Anemia of Chronic Disease

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anemia Anemia of Chronic Disease Health Hematology Hemostasis Hemostasis News Hemostasis Today Iron deficiency anaemia Medicine Samwel Omari Mikaye
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