Differential diagnosis of anemia of chronic disease and iron deficiency anemia

Table 9.1-2. Differential diagnosis of anemia of chronic disease and iron deficiency anemia
Parameter	Anemia
Parameter	Anemia of chronic disease	Iron deficiency anemia
Severity	Hb usually ≥9 g/dL	Variable
Symptoms	Variable	Variable
Coincident illness	Always (anemia may be the presenting manifestation)	Variable
RBCs	Usually normochromic and normocytic, but in patients with severe and long-lasting anemia it may be hypochromic and microcytic	Hypochromic and microcytic
Other cell lines	Usually normal but may reveal leukocytosis and high platelet counts (due to underlying condition)	Sometimes high platelet counts
Serum iron	↓	↓↓
TIBC	↓	↑
Serum ferritin	N or ↑	↓ (may be N or ↑ in the setting of coincident inflammation)
Serum soluble transferrin receptor	N	↑
Bone marrow iron	N or ↑	↓ or absent
↑, increased; ↓, decreased; Hb, hemoglobin; N, normal; RBC, red blood cell; TIBC, total iron-binding capacity.