Hematologie System

Anemia may be present in some patients due to impaired erythropoietin regulation, nutritional factors (vitamin E and iron malabsorption), or chronic inflammation. With chronic pulmonary disease, increased cytokine production can lead to shortened red blood cell survival, reduced erythropoietin response, and impaired mobilization of iron stores. Additionally, with chronic hypoxia, normal hemoglobin and hematocrit values may represent relative anemia.1 Increased red blood cell production is a physiological response to hypoxia; however, this response may be blunted in CF and may result in symptoms of anemia despite normal lab values.

Abnormal bleeding may also be observed as a result of vitamin K malabsorption or antibiotic-associated depletion of GI flora and vitamin K synthesis.

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