What is the diagnosis of a patient with raised ESR and hypochromic microcytic anemia thrombocytosis neutrophilia pleural effusion?

The most likely diagnosis is rheumatoid arthritis.

- Rheumatoid arthritis is a chronic autoimmune disorder that primarily affects the joints.

- Raised ESR is a common finding in rheumatoid arthritis, as inflammation leads to an increase in the production of acute phase proteins, such as fibrinogen and C-reactive protein, which increase the sedimentation rate of red blood cells.

- Hypochromic microcytic anemia is also commonly seen in rheumatoid arthritis, as the chronic inflammation can lead to iron deficiency, either through impaired iron absorption or increased iron utilization.

- Thrombocytosis is another common finding in rheumatoid arthritis, as the inflammation stimulates the production of thrombopoietin, which in turn increases platelet production.

- Neutrophilia is also often seen in rheumatoid arthritis, as the inflammation leads to an increase in the production of cytokines that stimulate the release of neutrophils from the bone marrow.

- Pleural effusion is not a typical finding in rheumatoid arthritis, but it can occur in some cases, especially if the inflammation is severe.