In anemia of chronic disease, red blood cell indices are typically which?

• A. Normocytic, normochromic
• B. Macrocytic
• C. Microcytic, hypochromic
• D. Spherocytes

Answer: (A)

Anemia of chronic disease usually shows a normocytic, normochromic red blood cell picture because the inflammatory process slows erythropoiesis and reduces iron availability for hemoglobin synthesis, but the cells produced are typically normal in size and Hb content. The body traps iron in storage and limits its release, so even though there is anemia, the average red cell remains normal in morphology initially. If the condition persists and iron becomes more restricted, a microcytic, hypochromic pattern can develop. Macrocytosis would point to other issues like B12 or folate deficiency, and spherocytes indicate a different type of hematologic problem altogether.