What laboratory findings are characteristic of anemia of chronic disease?

Anemia of chronic disease is typically characterized by normocytic anemia, which means that the red blood cells are of normal size but are decreased in number. A key feature of this type of anemia is its association with inflammation or chronic illnesses such as infections, autoimmune diseases, or malignancies.

In this condition, the body responds to inflammation by sequestering iron and reducing its availability for erythropoiesis, which leads to a diminished total iron-binding capacity (TIBC). This is because the liver produces more hepcidin, a regulatory hormone that limits iron absorption and release from storage, contributing to low serum iron levels. Despite the reduced availability of iron, the body has adequate stores, resulting in normal or even elevated ferritin levels, but because of the erythropoiesis disruption, the overall production of red blood cells is impaired.

Hence, the characteristic laboratory finding of anemia of chronic disease is normocytic anemia accompanied by a normal TIBC due to the sequestration of iron and the body's inflammatory response.