Anemia is a condition in which a person has low red blood cells, which are the cells in the blood that carry oxygen. Anemia of chronic disease (also called anemia of inflammation) is a condition associated with a number of different underlying diseases, including chronic illnesses and autoimmune and inflammatory diseases.
The most common cause of anemia is iron-deficiency. Anemia of chronic disease is the second most common cause of anemia in the U.S., and it is often a mild or moderate condition.
What Are Symptoms of Anemia of Chronic Disease?
Symptoms of anemia of chronic disease vary in severity depending on the underlying cause and how sick a person is, but in most cases, the anemia is usually mild or moderate.
Anemia of chronic disease may not cause any symptoms and patients learn they have it after blood tests are performed for another reason. Most of the time, the symptoms associated with the underlying causative disease are more significant than the mild or moderate anemia symptoms.
When symptoms of anemia of chronic disease occur, they may include:
- Fatigue/tiredness
- Weakness
- Headaches
- Pale skin (pallor)
- Lightheadedness
- Shortness of breath
- Fast heartbeat
- Irritability
- Chest pain
These symptoms may also be due to the person's underlying health condition and do not always indicate anemia.
What Causes Anemia of Chronic Disease?
Anemia of chronic disease can have various causes that depend upon the underlying condition.
The underlying chronic illness can cause a number of processes to be disrupted that can result in anemia:
- Shortened survival of red blood cells that occurs in patients with chronic inflammatory diseases
- Production of red blood cells is diminished because of decreased erythropoietin (EPO) (a hormone that plays a key role in the production of red blood cells) production and marrow responsiveness to EPO
- Iron metabolism changes due to an increase in hepcidin, which regulates iron metabolism in the blood, resulting in reduced iron absorption and recycling, leading to an imbalance in the distribution of iron in the body
How Is Anemia of Chronic Disease Diagnosed?
Anemia of chronic disease is diagnosed first by confirmation of a diagnosis of the underlying condition and a patient history.
A blood test can be used to diagnose anemia, but anemia of chronic disease is only suspected when a person has a chronic condition plus anemia.
Blood tests may include:
- Hemoglobin levels
- Blood iron levels
- Total iron binding capacity
- Overall red blood cell count
- Levels of ferritin
- Transferrin saturation
What Is the Treatment for Anemia of Chronic Disease?
Treatment of anemia of chronic disease is aimed at treating the underlying condition. If the underlying condition can be treated or managed, the anemia usually improves or goes away without specific treatment.
If treatment for the anemia is needed, it may include
- Iron supplements, either in pills or intravenously (IV)
- Erythropoietin or erythropoiesis-stimulating agents (ESAs) to help the body make more red blood cells (not commonly used)
- Blood transfusions (in severe cases)
