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Anemia of chronic disease

Definition

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia.

Anemia of chronic disease is a blood disorder that results from a long-term (chronic) medical condition that affects the production and lifespan of red blood cells.

See also: Anemia

Alternative Names

Anemia of inflammation

Causes, incidence, and risk factors

Anemia is a condition in which there is a lower than normal number of red blood cells in the blood. Certain chronic infections, inflammatory diseases, and other illnesses can affect the body's ability to produce red blood cells.

Conditions that can lead to anemia of chronic disease include:

• Autoimmune disorders, such as crohn's disease, systemic lupus erythematosus, rheumatoid arthritis, ulcerative colitis
• Cancer, particularly lymphoma and Hodgkin's disease
• Chronic kidney disease
• Liver cirrhosis
• Long-term infections, such as chronic bacterial endocarditis, osteomyelitis (bone infection), HIV/AIDS, hepatitis B or hepatitis C

Symptoms

Anemia of chronic disease is often mild and you may not notice symptoms, other than from the chronic disease itself.

Possible symptoms of anemia include:

• Chest pain
• Fatigue
• Paleness
• Shortness of breath

Signs and tests

The doctor will perform a physical examination.

Because anemia may be the first symptom of a serious illness, determining its cause is very important.

Tests that may be done to diagnose anemia or rule out other causes include:

• Hemoglobin level
• Red blood count
• Reticulocyte count
• Serum ferritin
• Serum iron
• Other blood tests

Treatment

The anemia is often mild enough that it requires no treatment, and will generally get better when the disease that is causing it is treated.

The condition is rarely severe enough to require a blood transfusion. Iron supplements may sometimes be used, although they should only be given to patients whose iron levels are low.

For some conditions, such as chronic kidney disease, shots of a medicine called erythropoietin may be given. These shots stimulate your bone marrow to make more blood cells.

Expectations (prognosis)

The anemia will improve when the disease that is causing it is successfully treated.

Complications

Discomfort from symptoms is the main complication in most cases. Anemia is associated with a higher risk of death in patients with heart failure.

Calling your health care provider

Call for an appointment with your health care provider if you have a chronic disorder and you develop symptoms of anemia.

References

Gardner LB, Benz Jr EJ. Anemia of chronic diseases. In: Hoffman R, Benz EJ, Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 37.