LivingDegree t1_j93yrje wrote
Yes! This is actually how you can pick up on chronic internal bleeding within the digestive tract (along with constitutional systems like black tarry stools/dark stools); it’s called anemia of chronic disease. You see this occur in your inflammatory bowel diseases. On routine labs you can see an anemia and it clues you into a long term inflammatory process if you can rule out diet deficiency or other hematological pathologies.
beyardo t1_j94jip4 wrote
Should be noted that anemia of chronic disease is separate from chronic blood loss anemia, although IBD can cause both. Anemia of chronic disease is a result of chronic inflammation decreasing your body’s synthesis of RBCs, while blood loss anemia like that seen in chronic bleeding is a result of losing blood
Bax_Cadarn t1_j95fqtg wrote
That's why chronic disease is normocytic while with blood loss is microcytic. Unless with long term small bleeds the body adapts to eventually make them normal size too.
beyardo t1_j9anb0e wrote
ACD often eventually becomes microcytic as well, as the inflammatory stuff eventually sequesters the iron until you get a relative iron deficiency
giskardwasright t1_j94uub2 wrote
To add to this we can tell on lab tests if it's chronic or acute anemia through red cell morphology. A slower chronic condition genetally results in red cells smaller than average size with less hemoglobin (microscopic hypochromic) where in an acute bleed situation the cells are normal sized and filled properly, just not enough of them. We can also tell how hard the bone marrow is working to replace cells by the presence and number of nucleated or immature rbcs.
I know you didn't ask, but I don't get to nerd out about this stuff often and I find it fascinating.
beyardo t1_j95g0o9 wrote
Depending on the cause, chronic anemia can be normocytic or even macrocytic, it’s not always microcytic
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