What distinguishes chronic disease anemia from other types of anemia?

Chronic disease anemia, often associated with conditions such as chronic infections, inflammatory diseases, or malignancies, is distinguished by its characteristic laboratory findings. In this type of anemia, patients typically exhibit high levels of ferritin, which is a protein that stores iron, alongside normocytic cells—meaning that the red blood cells appear normal in size under a microscope. The presence of high ferritin indicates that the body has adequate iron stores; however, due to the inflammation or chronic disease, the iron is not bioavailable for erythropoiesis (the production of red blood cells).

This mechanism is part of the body’s response to inflammation, where iron is sequestered as a protective measure against pathogens. The results generally show a normal-sized red blood cell (normocytic) because the underlying condition maintains some level of erythropoiesis, but it is insufficient to meet the body's needs due to the competing factors associated with chronic illness.

In contrast, other types of anemia present different characteristics: microcytic anemia typically shows small red blood cells and is often related to iron deficiency; macrocytic anemia exhibits larger than normal red blood cells, usually due to vitamin B12 or folate deficiency; and a low mean corpuscular volume (