<prompt> A 25-year-old woman has a 3-year history of arthralgias. Physical examination shows no joint deformity, but she appears pale. Laboratory studies show a total RBC count of 4.7 million mm3, hemoglobin of 12.5 gdL, hematocrit of 37.1, platelet count of 217,000 mm3, and WBC count of 5890 mm3. The peripheral blood smear shows hypochromic and microcytic RBCs. Total serum iron and ferritin levels are normal. Hemoglobin electrophoresis shows 93 hemoglobin A1 with elevated hemoglobin A2 level of 5.8 and hemoglobin F level of 1.2. What is the most likely diagnosis?Anemia of chronic diseaseAutoimmune hemolytic anemiab-Thalassemia minorInfection with Plasmodium vivax  <response>: Although b-thalassemia minor and iron deficiency anemia are both characterized by hypochromic and microcytic RBCs, there is no increase in hemoglobin A2 in iron deficiency states. A normal serum ferritin level also excludes iron deficiency. In contrast to b-thalassemia major, there is usually mild anemia without major organ dysfunction with b-thalassemia minor. Diseases that produce hemolysis and increase erythropoiesis e.g., autoimmune hemolytic anemia, malaria do not alter the composition of b-globin chain production. Anemia of chronic disease may mimic iron deficiency and thalassemia minor with respect to hypochromia and microcytosis; however, anemia of chronic disease is associated with an increase in the serum concentration of ferritin. 