anaemia of chronic disease


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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 ?
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.
Anaemia of chronic disease plays a very important role in this population group, as inhibition of iron transfer from the reticulo-endothelial cells to the erythroid precursors due to inflammation is estimated to occur in 18-95% of cases.
The underlying mechanisms of anaemia in cardiac failure mean that first-time attendees may not have a high prevalence of anaemia because chronic cytokine release might not have had the critical cumulative effect leading to anaemia of chronic disease.
12) Iron deficiency anaemia (IDA) and the anaemia of chronic disease (ACD) are the most common causes.
Erythropoietic agents should be used together with intravenous iron in IBD patients with the anaemia of chronic disease.
For more detailed information on the anaemia of infection and the anaemia of chronic disease, the reader is referred to two recent comprehensive reviews.
The etiology of the anaemia of chronic disease and infection.
Anaemia of chronic disease (ACD) is a multifactorial anaemia often coexistent with iron deficiency.
Microcytosis (mean corpuscular volume (MCV) lower than normal range) is characteristic of chronic iron deficiency, but can occur in other conditions such as thalassaemia and anaemia of chronic disease.
True (A) or false (B)--fill in only block A or B: Anaemia of chronic diseases may also be normocytic-hypochromic or microcytic-hypochromic when it is associated with concomitant iron deficiency.