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Anaemia of chronic disease

Anaemia 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 anaemia.

Anemia of chronic disease (ACD) is anemia that is found in people with certain long-term (chronic) medical conditions that involve inflammation.

Causes

Anemia is a lower-than-normal number of red blood cells in the blood. ACD is a common cause of anemia. Some conditions that can lead to ACD include:

  • Autoimmune disorders, such as Crohn disease, systemic lupus erythematosus, rheumatoid arthritis, and ulcerative colitis
  • Cancer, including lymphoma and Hodgkin disease
  • Long-term infections, such as bacterial endocarditis, osteomyelitis (bone infection), HIV/AIDS, lung abscess, hepatitis B or hepatitis C

Symptoms

Anemia of chronic disease is often mild. You may not notice any symptoms.

When symptoms occur, they may include:

  • Feeling weak or tired
  • Headache
  • Paleness
  • Shortness of breath

Exams and Tests

The health care provider will perform a physical exam.

Anemia may be the first symptom of a serious illness, so finding its cause is very important.

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

  • Complete blood count
  • Reticulocyte count
  • Serum ferritin level
  • Serum iron level
  • C-reactive protein level
  • Erythrocyte sedimentation rate
  • Bone marrow examination (in rare cases to rule out cancer)

Treatment

Anemia is often mild enough that it does not need treatment. It may get better when the disease that is causing it is treated.

More severe anemia, such as that caused by chronic kidney disease, cancer, or HIV/AIDS may require:

  • Blood transfusion
  • Erythropoietin, a hormone produced by the kidneys, given as a shot

Prognosis

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

See also  Aplastic anaemia

Possible Complications

Discomfort from symptoms is the main complication in most cases. Anemia may lead to a higher risk for death in people with heart failure.

When to Contact a Medical Professional

Call your provider if you have a long-term (chronic) disorder and you develop symptoms of anemia.

Alternative Names

Anemia of inflammation; Inflammatory anemia; AOCD; ACD

References

Means RT. Approach to the anemias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 149.

Nayak L, Gardner LB, Little JA. Anemia of chronic diseases. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 37.