<prompt> A 60-year-old lady with a history of rheumatoid arthritis has the following lab findings: Hb 4.5 gdL, Platelet count 200 mgdL, TLC 6000mm3, serum ferritin-200 mgL. TIBC-280 ngL. What is the most likely diagnosis?Iron deficiency deficiencyAnemia of chronic diseaseThalassemia minorAutoimmune haemolytic anemia  <response>: Ans. b. Anemia of chronic disease Ref: Wintrobes 12e pe p 1221-1222Anemia of chronic disease is associated with decreased serum iron, decreased TIBC, decreased saturation and normal or increased serum ferritin levels.Testnormal valuesIrondeficiencyThalassemiaSideroblastic anemiaAnemia of chronic diseaseSmearMicrocytichypochromicMicrocytichypochromicMicrocytichypochromicNormocytic normochromic Micro hypochromicSerum iron 50-150 mgdlLow 30NormalNormal 50TIBC300-360 mgdlHigh 360NormalNormal 300 Saturation 30-5010 edN or ed 30-80N or 30-80 10-20Ferritin mgl 50-200 mgL 15 ed 50-300 50-300Normal or 30-200Hemoglobin patternNormalAbnormalNormalNormalFree Erythrocyte ProtporphrinedNormalededRDWedNormalNormalNormalAnemia of Chronic DiseaseCharacterized by block in delivery of ironQ from the reticuloendothelial system to the erythroid progenitors.Consequently patients have normal to increased iron stores in the marrow and normal to increase ferritin IevelQ.Because of block in delivery, serum iron levels fall and so does TIBC and transferrin saturationQ.Low serum iron with increased TIBCIron deficiency anemiaQLow serum iron with decreased TIBCAnemia of chronic diseaseQ 