Anemia of chronic disease: Evaluating iron markers and bone marrow findings

Anemia of chronic disease (ACD) is a common condition associated with chronic inflammation, characterized by disordered iron metabolism and impaired erythropoiesis. This study evaluated iron metabolism markers and correlated them with bone marrow iron stores in 100 patients with anemia in chronic disease settings. Parameters including serum iron, ferritin, total iron-binding capacity (TIBC), transferrin saturation (TSAT) and soluble transferrin receptor (sTfR) were analyzed alongside bone marrow iron grading using Perls' Prussian blue staining. Most patients demonstrated low serum iron and TSAT with normal to elevated ferritin levels, while increased sTfR in some cases suggested coexisting iron deficiency. Data shows that integrating serum ferritin and sTfR with bone marrow iron grading provides a more reliable framework for distinguishing anemia of chronic disease from coexisting iron deficiency, supporting a dual biochemical-morphological approach over single-marker evaluation in routine clinical practice.