You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Which laboratory determinations would be most helpful in distinguishing iron deficiency anemia from anemia of chronic disease? and explain in detail?
This is a common clinical scenario in real life. Serum ferritin is markedly decreased in iron deficiency anemia and is normal to modestly elevated in anemia of chronic disease. This difference makes this test very useful in this setting. You should be aware that serum ferritin may behave like an acute phase reactant. Therefore, in an acute inflammatory situation, erythrocyte ferritin may be more reliable if serum ferritin is equivocal. Also, do not forget that iron deficiency anemia can complicate the anemia of chronic disease (e.g., gastrointestinal bleeding can complicate gastrointestinal cancers); in this situation, most physicians treat the apparent iron deficiency anemia and see to what degree the anemia corrects. The erythrocyte: granulocyte ratio in bone marrow is slightly decreased in both iron deficiency anemia and anemia of chronic disease, but may be markedly increased in sideroblastic anemias. Polychromatophilic target cells and stippled erythrocytes are absent in both iron deficiency anemia and anemia of chronic disease, but may be present in sideroblastic anemias and other iron-utilization anemias. Ref - Harrison's principles of internal medicine 20e pg 685,686,688