non-sideropenic hypochromic anaemia non-sideropenic hypochromic anaemia sideropenic hypochromic anemia is primarily characterized by low serum iron concentration. non-sideropenic hypochromic anemia is the ineffective utilisation of iron stores, usually from chronic infection/inflammation. it is very important to distinguish iron deficit anemia from the anemia of chronic disorders so as to ensure specific treatment. basic features 1- red cell indices and blood film appearances suggest iron deficiency, although peripheral blood changes are not usually as marked as in moderate or severe iron deficiency. 2- erythropoiesis is abnormal because of ineffective iron utilisation with poor haemoglobinisation of red cell precursors and 3- bone marrow iron stores are normal or increased and sideroblasts may be frequent and abnormal. causes 1- secondary anemias - chronic infection/inflammation - malignancy 2- thalassaemia 3- sideroblastic anaemia "differentiation from iron deficiency" the serum iron and total iron-binding capacity (transferrin) are helpful but not diagnostic; it is quite possible to have co-existing ineffective iron utilisation and iron deficiency, as determined by bone marrow iron status, e.g. in rheumatoid arthritis.