Question

Examination of the bone marrow revealed erythroid hyperplasia with a shift to the left of erythroid precursors. Prussian blue staining revealed markedly elevated iron stores noted with occasional sideroblasts seen. This data is most consistent with which of the following conditions?

iron deficiency anemia
anemia of chronic disease
hemochromatosis
acute blood loss

Answer 1

The findings of erythroid hyperplasia, elevated iron stores, and sideroblasts align with the characteristics of hemochromatosis, a condition involving excessive iron accumulation.

Step-by-step explanation:

The clinical finding of erythroid hyperplasia with a shift to the left, which refers to an increase in immature erythroid precursors, combined with elevated iron stores and the presence of sideroblasts, is closely associated with conditions where there is excessive iron within the body. In this case, the described symptoms are most consistent with hemochromatosis, which is characterized by increased iron absorption and deposition in various organs, including the liver, spleen, and bone marrow.

Iron deficiency anaemia typically presents with low iron stores, which is in contrast to the provided scenario. Anaemia of chronic disease often involves impaired iron utilization but not necessarily increased iron stores, while acute blood loss usually presents with low iron levels due to the loss of blood.

Conditions such as aplastic anaemia and polycythemia vera are different blood disorders with distinguishing features that do not match the findings of markedly increased iron stores and occasional sideroblasts observed in this case.

Answer 2

The bone marrow findings of erythroid hyperplasia and elevated iron stores are most consistent with anemia of chronic disease or sideroblastic anemia, as these conditions are characterized by increased iron within the bone marrow.

Step-by-step explanation:

The examination of the bone marrow showing erythroid hyperplasia with a shift to the left of erythroid precursors and Prussian blue staining revealing markedly elevated iron stores with occasional sideroblasts is most consistent with the condition of anemia of chronic disease or sideroblastic anemia. This type of anemia is characterized by the presence of sideroblasts and increased iron in the bone marrow. In contrast to other forms such as iron deficiency anemia, theiron stores are elevated, not depleted, making conditions such as hemochromatosis or acute blood loss less likely. However, distinguishing between anemia of chronic disease and sideroblastic anemia specifically requires additional clinical correlation.