Usefulness of Old and New Diagnostic Tests in ACD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Distinguishing the Anemia of Chronic Disease from Other

The diagnosis of anemia of chronic disease (ACD) is largely based on exclusion of other causes of anemia. The hemolytic anemias can usually be easily excluded on the basis of the absence of signs of hemolysis, such as elevated reticulocyte

count and reduced serum haptoglobin concentration. An increasingly important type of anemia, pernicious anemia, is due to inadequate absorption of vitamin B12. Pernicious anemia is macrocytic and megaloblastic, and in addition it can be distinguished from ACD on the basis of reduction in serum levels of vitamin B12 or related metabolites.