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Anaemia of Chronic Disease

 
 
 
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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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