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Anemia of Inflammation

(Anemia of Chronic Disease; Hypoferremia of Inflammatory Disease; ACD)

by Alice A. McCarthy, MBA

• Definition • Causes • Risk Factors • Symptoms • Diagnosis • Treatment • Prevention
En Español (Spanish Version)
 

Definition

Certain long-term medical conditions can cause anemia. Anemia is a low level of healthy red blood cells (RBCs). RBCs carry oxygen from the lungs to the rest of the body. When red blood cells are low, the body does not get enough oxygen.

Hemoglobin

Copyright © Nucleus Medical Media, Inc.

 

Causes    TOP

Anemia has several causes, but some may be unknown. Factors that play into anemia include:

  • Shortened lifespan of red blood cells
  • The body is not making enough new red blood cells
  • Lower release of a hormone that stimulates the body to make red cells
  • Problems with use of iron within the body

Long-term illnesses that can lead to anemia, include:

  • Chronic infections, such as tuberculosis, lung abscess, and subacute endocarditis
  • Noninfectious inflammatory diseases, such as rheumatoid arthritis, osteomyelitis, systemic lupus erythematosus, and inflammatory bowel disease
  • Common childhood infections, including ear infections and urinary tract infections
  • Heart failure, thyroid disease, and kidney failure
  • Cancer, particularly Hodgkin disease, lung cancer, and breast cancer
 

Risk Factors    TOP

Anyone with one of the conditions listed above may be at risk. There is a higher risk for it among the elderly.

 

Symptoms    TOP

Anemia often develops slowly. There may be few or no symptoms. Most symptoms are mild but may include:

  • Pale complexion
  • Lightheadedness
  • Fatigue
  • Rapid heartbeat
  • Fever
 

Diagnosis    TOP

You will be asked about your symptoms and past health. A physical exam will be done. Blood tests will show how many RBCs you have and how healthy they are. A diagnosis can be made based on blood tests and your health history.

 

Treatment    TOP

Anemia may improve if the underlying disease is treated.

Blood transfusions may be needed if the anemia is severe. It will supply healthy RBCs from a donor.

Medicine may also be used to encourage the growth of RBCs. This group of medicine is called erythropoiesis-stimulating agents (ESAs). This medicine may not be an option because of side effects. It can make some cancers worse.

 

Prevention    TOP

It is not clear how to prevent this anemia. Managing some chronic conditions may reduce the risk of anemia.

RESOURCES:

Iron Disorders Institute
http://www.irondisorders.org

National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Health Canada
https://www.canada.ca

REFERENCES:

Anemia of inflammation. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/anemia-of-inflammation/ . Updated June 13, 2019. Accessed September 13, 2019.

Explore anemia. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/anemia. Updated May 18, 2012. Accessed September 13, 2019.

Ganz T. Anemia of Inflammation. N Engl J Med 2019; 381:1148-1157.

Nemeth E, Ganz T. Anemia of inflammation. Hematol Oncol Clin North Am. 2014 Aug;28(4):671-81

Weiss G, Ganz T, Goodnough LT. Anemia of inflammation. Blood. 2019 Jan 3;133(1):40-50.



Last reviewed September 2019 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 8/5/2020

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