In a patient with systemic lupus erythematosus, what is the most likely diagnosis when presenting with anemia and no menstrual irregularities?

In the context of systemic lupus erythematosus (SLE), anemia of chronic disease is the most likely diagnosis in a patient presenting with anemia and no menstrual irregularities. This type of anemia is associated with chronic inflammatory conditions, including autoimmune diseases like SLE.

In SLE, there is often an increased production of inflammatory cytokines that can lead to the sequestration of iron and impaired erythropoiesis, resulting in anemia. This anemia typically presents with a mild decrease in hemoglobin levels and can be detected in patients without any significant blood loss or nutritional deficiencies, making it distinct from other types of anemia.

The absence of menstrual irregularities supports the idea that the anemia is not due to conditions like iron deficiency anemia, which is commonly seen in women of childbearing age due to menstrual blood loss. Meanwhile, pernicious anemia involves vitamin B12 deficiency, often linked to malabsorption rather than a direct consequence of chronic inflammation. Beta thalassemia minor is a genetic condition and usually does not present as a direct consequence of an autoimmune condition like SLE.

Thus, anemia of chronic disease aligns well with the patient's overall clinical picture in the setting of systemic lupus erythematosus.