A 29-year-old man with newly diagnosed Crohn disease limited to the terminal ileum presents with abdominal pain, bloody diarrhea, and fever (38.2°C). Vital signs: BP 118/76, HR 92, RR 18, SpO2 98% on room air. He denies melena. Laboratory studies reveal hemoglobin 9.8 g/dL, MCV 72 fL, ferritin 15 ng/mL, iron saturation 16%, and normal B12 level. CT enterography confirms segmental inflammation. Which of the following best explains his anemia?
- A)Folate deficiency from sulfasalazine use
- B)Autoimmune hemolytic anemia secondary to IBD
- C)Vitamin B12 deficiency from terminal ileal disease
- D)Chronic disease anemia from inflammation alone
- E)Iron deficiency anemia from chronic GI blood lossGABARITO
Explicação
The microcytic anemia (MCV 72) with low ferritin (15) and low iron saturation (16%) is classic for iron deficiency anemia. In Crohn disease, chronic mucosal inflammation and blood loss, even if occult, lead to iron depletion. Terminal ileal disease may later c... Ver explicação completa e trilha adaptativa →