In anemia of chronic disease/inflammation, inflammation caused by an underlying disorder slows the production of red blood cells due to reduced iron availability.
(See also Overview of Anemia.)
Inflammatory anemia may develop people with a chronic disease (for example, heart failure or chronic kidney disease), a systemic autoimmune disease, an infection, or cancer. Worldwide, anemia of chronic disease is the second most common type of anemia.
Chronic disease often leads to anemia, especially in older adults. Conditions such as infections, autoimmune disorders (especially rheumatoid arthritis), kidney disorders, and cancer most often cause anemia of chronic disease. There are 3 ways that chronic disease may cause anemia:
Problems with how the body uses iron
Suppression of the production of red blood cells in the bone marrow
Decrease in the lifespan of red blood cells
Suppression of red blood cell production is usually not severe, so anemia develops slowly and is evident only after time.
There is a problem with how the body uses iron, therefore, the bone marrow is unable to use stored iron to create new red blood cells.
Because anemia of chronic disease develops slowly and is generally mild to moderate, it usually causes few or no symptoms. When symptoms (for example, fatigue, weakness, or paleness) do occur, they may result from the disease causing the anemia rather than from the anemia itself.
Diagnosis of Anemia of Chronic Disease
Blood tests
There are no specific laboratory tests to diagnose anemia of chronic disease, so the diagnosis is typically made by excluding other causes of anemia. Iron studies can suggest the diagnosis. In people who have anemia of chronic disease of unknown cause, doctors may do blood tests to diagnose the disorder causing the anemia.
Treatment of Anemia of Chronic Disease
Treatment of the disorder causing anemia
Sometimes medications to stimulate red blood cell production
Because no specific treatment exists for this type of anemia, doctors treat the disorder causing it. In certain cases, such as chronic kidney disease, erythropoietin or darbepoietin, medications that stimulate the bone marrow to produce red blood cells, may be given. Iron supplements are usually given when using erythropoietin or darbepoietin to ensure the body reacts appropriately to these medications. Medications that stimulate red blood cell production (by stimulating erythropoietin, the signal that triggers such production) are not as helpful unless iron stores are adequate. Iron deficiency can coexist with anemia of chronic disease/inflammation ,and iron supplementation is also indicated in these cases.
On the rare occasion that the anemia becomes severe, transfusions may help.
