Anemia of Chronic Disease

Anemia of Chronic Disease is a type of anemia that is part of a long disease like chronic infection or cancer. Like other anemia, signs and symptoms include easy fatigability, dizziness, and  pallor.

Causes

Anemia of chronic disease may occur due to the following:

1.There is shortened RBC survival due to still unknown mechanisms(normally, RBC lives for 120 days).

2.In chronic diseases there is decreased bone marrow responsiveness to erythropoietin. Erythropoietin is a hormone that stimulates the bone marrow to produce red blood cells.

3. Iron metabolism is impaired.

Diagnosis

To diagnose anemia of chronic disease, a complete blood count is performed. The hemoglobin is and RBC count is decreased. Ferritin, the storage form of iron in the body is also measured and is also decreased. In special laboratories, erythropoietin levels is measured and is usually decreased.

Treatment

Management includes treating the underlying cause. Commercially prepared Erythropoeitin (EPO) maybe given to the patient. EPO dose may need to be 150 to 300 units/kg sc 3 times/wk. A good response is likely if after 2 weeks of therapy hemoglobin has increased (> 0.5 g/dL) and serum ferritin is < 400 ng/mL.

Iron supplements in the form of ferrous sulfate or fumarate maybe given to patients once a day.

_{References:
http://www.nejm.org/doi/full/10.1056/NEJMra041809 visited last Dec.15,2010
http://www.merckmanuals.com/professional/sec11/ch130/ch130d.html visited last Dec 15,2010}