This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Haematology, Subject name: Pathology
Anemia of chronic disease is due to - 
Select and explain. 
A. Vit B12 deficiency, B. Folate deficiery, C. Decreased utilization of stored iron, D. Chronic blood loss
C: Decreased utilization of stored iron
Answer: C: Decreased utilization of stored iron 
Explanation: Chronic diseases produce massive elevation of Interleukin-6, released from the liver,which stimulates hepcidin production, which in turn reduces the iron carrier protein ferropoin so that access of iron to the circulation is reduced. Other mechanisms may also play a role, such as reduced erythropoeisis. It is associated with low serum iron, reduced total iron binding capacity and abundant stored iron in tissue macrophages. Peripheral smear shows predominantly normocytic and normochromic picture or sometimes microcytic hypochromic picture. Vitamin B12deficiency,folate deficiency causes megaloblastic anemia Chronic blood loss causes Iron deficiency anemia. reference :Robbins and Cotrans Pathologic Basis of Disease, 9th edition, 652.