Which mechanism best explains the low serum iron and functional iron restriction seen in anemia of chronic disease?

• A Suppressed hepatic hepcidin secretion increases ferroportin channels on macrophages
• B Inflammatory cytokines directly inhibit transferrin receptor 1 on erythroid precursors
• C Interleukin 6 driven hepcidin binds ferroportin and causes its internalization, trapping iron in macrophages ✓
• D Tumor necrosis factor accelerates catabolism of stored ferritin

Explanation

Inflammation raises IL 6, which drives hepatic hepcidin production. Hepcidin binds the iron exporter ferroportin on enterocytes and macrophages, triggering its internalization and degradation, so absorbed and recycled iron stays locked inside stores. This explains high ferritin with low serum iron and poor oral iron response. The killer fact against option A: suppressed hepcidin produces iron overload states such as hereditary hemochromatosis, the opposite physiology.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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