رجل عمره ٤٥ سنة عنده تعب منذ ٣ أشهر، والهيموغلوبين ١٠٫٢، والكريات طبيعية الحجم. عنده التهاب مفاصل روماتويدي نشط منذ سنوات. الفيريتين طبيعي مرتفع قليلاً، والحديد منخفض. ما الأرجح؟

A 45-year-old with active rheumatoid arthritis for years has had fatigue for 3 months. Hb 10.2 g/dL with normal-sized cells, ferritin normal to slightly high and serum iron low. What is most likely?

1. Vitamin B12 deficiency anaemia
2. Severe iron-deficiency anaemia
3. Thalassaemia major
4. Anaemia of chronic disease

Answer: D) Anaemia of chronic disease. Chronic inflammation traps iron in cells, so serum iron is low with normal or high ferritin; treatment is controlling the underlying disease.