Which type of anemia is seen in patients of rheumatoid ahritis?
**Core Concept**
Anemia of chronic disease (ACD) is a type of anemia that occurs in patients with chronic inflammatory conditions, including rheumatoid arthritis. It is characterized by a decrease in iron availability and utilization, leading to impaired erythropoiesis.
**Why the Correct Answer is Right**
In ACD, the chronic inflammation stimulates the production of hepcidin, a hormone that regulates iron metabolism. Hepcidin binds to ferroportin, the only known iron exporter, and induces its internalization and degradation, leading to a decrease in iron release from macrophages and a subsequent decrease in iron availability for erythropoiesis. This results in a normocytic, normochromic anemia.
**Why Each Wrong Option is Incorrect**
**Option A:** Iron deficiency anemia is incorrect because it is characterized by a lack of dietary iron, not an excess of hepcidin.
**Option B:** Sideroblastic anemia is incorrect because it is characterized by an accumulation of iron within mitochondria of erythroblasts, leading to the formation of sideroblasts.
**Option C:** Hemolytic anemia is incorrect because it is characterized by an increased rate of red blood cell destruction, not a decrease in iron availability for erythropoiesis.
**Clinical Pearl / High-Yield Fact**
Remember that anemia of chronic disease is a common cause of anemia in patients with chronic inflammatory conditions, and it should be considered in the differential diagnosis of anemia in these patients.
**Correct Answer:** C. Anemia of chronic disease.