Table 8.5-2. Differential diagnosis of anemia of chronic disease and iron deficiency anemia

Parameter

Anemia

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.