Anemia of chronic disease (ACD), also referred to as anemia of inflammation, is clearly responsible for many cases of anemia observed in the elderly.
Anemia of chronic disease in rheumatoid arthritis is associated with increased apoptosis of bone marrow erythroid cells: Improvement following anti-tumor necrosis factor-alpha antibody therapy.
Baseline demographics and disease characteristics Variable Value n % Mean[+ or -]SD Age, years 37.3[+ or -]7.9 Sex Male 35 81.4 Female 8 18.6 Disease duration (years) 5.14[+ or -]3.4 HLA-B27 positivity 37 86.0 Drugs before anti-TNF therapy NSAIDs 1 2.3 NSAIDs + sulfasalazine 9 20.9 NSAIDs + sulfasalazine + methotrexate 33 76.7 Duration of DMARD treatment before anti-TNF therapy (months) 31.9[+ or -]20.0 Anemia 12 27.9
Anemia of chronic disease 4 9.3 Iron deficiency anemia 8 18.6 Anti-TNF inhibitors Etanercept 26 60.4 Infliximab 14 32.6 Adalimumab 3 7.0 HLA: Human leukocyte antigen; NSAIDs: Non-steroidal anti-inflammatory drugs; DMARDs: Disease-modifying anti-rheumatic drugs; TNF: Tumor necrosis factor-alpha; Values are expressed as mean [+ or -] standard deviation unless otherwise stated.
This increased synthesis leads to a deficiency of iron available for erythropoiesis, and is considered to be the mechanism underlying reticuloendothelial (RE) iron sequestration, intestinal iron absorption impairment, and low serum iron concentrations characteristic of
anemia of chronic disease.
Advances in the
anemia of chronic disease. Int J Hematol 1999; 70: 7-12.
Several diseases result in normocytic anemia, including aplastic anemia, acute blood loss, hemolytic anemia, and
anemia of chronic disease (Gaspad, 2005; Young, Calado, & Scheinberg, 2006).
We'll never get questions about
anemia of chronic disease or uncontrolled hypertension or diabetes.
A test for iron, total iron-binding capacity, percentage saturation of iron-binding capacity, ferritin and soluble transferrin receptor levels will distinguish
anemia of chronic disease (ACD) from iron-deficiency anemia (IDA).
The diseased control group consisted of patients with rheumatoid arthritis and
anemia of chronic disease.
Anemia of chronic disease. New England Journal of Medicine, 5, 352, 1011-1023.
Is Obesity Associated With
Anemia of Chronic Disease? A Population-based Study: Obesity 2008; 16: 2356-2361.
In contrast, in
anemia of chronic disease and anemia of cancer, data suggest that hepcidin concentrations are increased, causing decreased absorption of iron and increased sequestration of iron in the reticulo-endothelial system, which together account for the observed anemia (6, 14-18).