anaemia of chronic disease

anaemia of chronic disease

A form of anaemia that accounts for 1/4 of all anaemias in hospitalised patients; it is the predominant form of hypoproliferative anaemia, which interferes with RBC production and shortens RBC lifespan, and is seen in patients with arthritis, chronic infections, and malignancy.
 
Clinical findings
The findings in anaemia of chronic disease reflect the underlying aetiology.

Lab
Mild-to-moderate anaemia, often microcytic ± hypochromic; iron stores may be low/normal; RBC indices may be normal.
 
Pathogenesis
Unknown; possibly related to IFN-gamma produced by activated macrophages.
 
Management
Transfusion, erythropoietin.
References in periodicals archive ?
A more nuanced approach may be warranted in primary care, where iron deficiency anaemia (IDA) [2] and anaemia of chronic disease (ACD) are common.
It is an acute-phase reactant and its level increases in liver damage and inflammatory states while its level decreases in iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD).
In our study, we are estimating the prevalence of anaemia in patients above 55 years and on evaluating the causes of anaemia, the most common causes of anaemia in older age group are anaemia of chronic disease, nutritional anaemia, post haemorrhagic anaemias and malignancies.
Anaemia of chronic disease was present in 53% of the patients with renal insufficiency as the most frequent pathology seen in 11% patients.
Similar results were obtained with anaemia of chronic disease and iron deficiency anaemia (ICD: change [Hb] =+0.
The aetiology of anaemia in HIV infection is multifactorial and typically the anaemia results from underproduction of red blood cells and frequently the laboratory features are compatible with anaemia of chronic disease with a low reticulocyte count, normocytic and normochromic red blood cells with normal iron stores and cytokine mediated poor erythropoietin response (9-11).
Anaemia of chronic disease plays a very important role in this population group, and is estimated to occur in 18 - 95% of cases.
12) Iron deficiency anaemia (IDA) and the anaemia of chronic disease (ACD) are the most common causes.
Accurate diagnosis demands differentiation of IDA from the anaemia of chronic disease (ACD), also referred to as anaemia of inflammation.
The hepcidin assay has promise in diagnosing pure IDA (low levels) from anaemia of chronic disease (ACD) or combined IDA/ ACD, where the levels are higher.