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  4. We’ve been discussing malabsorption in patients with gut infections and other conditions. Can you comment on the propensity for “anemia of chronic disease” to be likely in undiagnosed gut infection versus just abnormal iron metabolism?

We’ve been discussing malabsorption in patients with gut infections and other conditions. Can you comment on the propensity for “anemia of chronic disease” to be likely in undiagnosed gut infection versus just abnormal iron metabolism?

Dr. Amy Nett: I think it’s reasonable to think that some cases of anemia could certainly be due to low iron or possibly nutrient deficiencies, but that said, anemia of chronic disease is more often characterized by a low MCV, and when we talk about malabsorption with gut infections, a lot of what we’re seeing is actually malabsorption of vitamin B12 and folate. If you have a functional B12 and folate deficiency, you’re actually going to have a high MCV. I think there’s a lot we still don’t know about anemia of chronic disease, but that said, I don’t think it’s all due to gut infections and nutrient deficiencies because, again, when you’re looking at a small MCV, that’s not going to be in line with a vitamin B12 and folate deficiency.

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