A 44-year-old white man consulted his primary provider because of pain in his shoulder and fingers. The physical examination revealed no major abnormalities but his liver was slightly enlarged and tender. A CBC and blood studies were ordered, with the following results:
Parameter
Result
Reference Range
Hemoglobin
14 g/dL
14-18 g/dL
Hematocrit
42%
42-52%
Serum iron
37 µg/dL
50-160 µg/dL
Serum ferritin
2,430 ng/mL
15-400 ng/mL
% Saturation
95%
20-55%
A liver biopsy was performed. Tissue sections revealed fatty metamorphosis and an increase in fibrous tissue in portal areas consistent with early cirrhosis. Large amounts of parenchymal iron were noted with Prussian blue staining.
Does this man have anemia? Why or why not? Based on the laboratory results and the patient history, what is the most likely diagnosis? What morphology would you expect to see in the peripheral blood? What is the most common cause of this disorder?
A 44-year-old white man consulted his primary provider because of pain in his shoulder and fingers. The physical examination revealed no major abnormalities but his liver was slightly enlarged and tender. A CBC and blood studies were ordered, with the following results:
| Parameter | Result | Reference Range |
| Hemoglobin | 14 g/dL | 14-18 g/dL |
| Hematocrit | 42% | 42-52% |
| Serum iron | 37 µg/dL | 50-160 µg/dL |
| Serum ferritin | 2,430 ng/mL | 15-400 ng/mL |
| % Saturation | 95% | 20-55% |
A liver biopsy was performed. Tissue sections revealed fatty metamorphosis and an increase in fibrous tissue in portal areas consistent with early cirrhosis. Large amounts of parenchymal iron were noted with Prussian blue staining.
Does this man have anemia? Why or why not? Based on the laboratory results and the patient history, what is the most likely diagnosis? What morphology would you expect to see in the peripheral blood? What is the most common cause of this disorder?
