Overview
The anaemia of chronic disease is a common condition that is associated with chronic infection, inflammation or malignancy where patients develop a non-specific anaemia.
Pathogenesis
- The condition is multifactorial, and occurs in the context of:
- Reduced effective incorporation of iron into haemoglobinDue to increased production and release of hepcidin and cytokines
- Reduced responsiveness to erythropoietin
- Reduced red cell survival
Causes of Anaemia of Chronic Disease
- Chronic infection - bacterial, viral, fungal, parasitic
- Chronic inflammation - SLE, rheumatoid arthritis, inflammatory bowel disease, vasculitis, sarcoidosis, solid organ transplant rejection
- Chronic kidney disease
- Malignancy
Diagnosis
Test Findings in Anaemia of Chronic Disease
Full Blood Count & Film
- Anaemia - normocytic normochromic, or microcytic hypochromic
- Evidence of chronic inflammation - rouleaux, thrombocytosis
Other Tests
- Iron studies - reduced serum iron and transferrin; normal or increased ferritin, normal soluble transferrin receptor
- Inflammatory markers - increased ESR / CRP, reduced albumin
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