What is the typical red blood cell morphology in anemia of chronic disease?

What is the typical red blood cell morphology in anemia of chronic disease?

• A. Normocytic, normochromic RBC
• B. Hypochromic, microcytic RBC
• C. Macrocytic RBC
• D. Spherocytic RBC

Answer: (A)

Anemia of chronic disease typically presents with normocytic, normochromic red blood cells. The cells are normal in size and in hemoglobin content despite the overall anemia because inflammation slows production and iron availability for erythropoiesis without changing the appearance of the cells produced. Inflammatory cytokines raise hepcidin, which reduces iron absorption and traps iron in macrophages, leading to less iron for making new red cells. As a result, the marrow’s output is diminished but the circulating cells that are produced remain normal in size and color. If iron stores become depleted over time or iron deficiency coexists, microcytosis with hypochromia can occur, but the classic picture is normocytic, normochromic. Hypochromic, microcytic cells point toward iron deficiency or thalassemia; macrocytosis suggests B12/folate deficiency or other causes; spherocytes indicate membrane or autoimmune hemolysis.

Anemia of chronic disease typically presents with normocytic, normochromic red blood cells. The cells are normal in size and in hemoglobin content despite the overall anemia because inflammation slows production and iron availability for erythropoiesis without changing the appearance of the cells produced. Inflammatory cytokines raise hepcidin, which reduces iron absorption and traps iron in macrophages, leading to less iron for making new red cells. As a result, the marrow’s output is diminished but the circulating cells that are produced remain normal in size and color. If iron stores become depleted over time or iron deficiency coexists, microcytosis with hypochromia can occur, but the classic picture is normocytic, normochromic. Hypochromic, microcytic cells point toward iron deficiency or thalassemia; macrocytosis suggests B12/folate deficiency or other causes; spherocytes indicate membrane or autoimmune hemolysis.