In a patient with long-standing rheumatoid arthritis, what type of anemia is likely present?

In the context of long-standing rheumatoid arthritis, the most likely type of anemia present is anemia of chronic disease. This form of anemia often arises in the setting of chronic inflammatory conditions, such as rheumatoid arthritis, due to the body's immune response. Inflammatory cytokines released during such conditions can lead to the sequestration of iron, impairing the availability of iron for hemoglobin synthesis.

Additionally, these cytokines can also suppress erythropoiesis in the bone marrow. As a result, despite the presence of adequate or even increased levels of iron in the body, the chronic inflammatory state disrupts the normal production of red blood cells, leading to anemia characterized by normocytic or mildly microcytic red blood cells.

This understanding highlights the importance of recognizing the underlying inflammatory processes that contribute to anemia in patients with chronic diseases like rheumatoid arthritis, making anemia of chronic disease the correct answer in this scenario.