Anemia of Chronic Disease

1. Causative Factors/Risk Factors

1.1. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn's disease and other chronic inflammatory diseases — can interfere with the production of red blood cells

1.2. Commonly found in patients with CHF

1.3. The elderly at higher risk secondary to increased concentrations of inflammatory cytokines

1.4. Strong family history

2. Diagnostic Tests/Treatments

2.1. Diagnosed by reduced levels of transferrin and low levels of circulating iron- less than 60 mpg/dl

2.2. High total body iron storage levels

2.3. Failure to respond to iron replacement therapy

2.4. Principal treatment is correcting the underlying disorder

2.5. Anemic chronic kidney patients can be treated with erythropoietin

2.6. Unfortunately, treatment with erythropoietin associated with other conditions has not been successful, and transfusions may worsen patients conditions

3. Signs/Symptoms

3.1. Can range from mild to moderate

3.2. Fatigue Weakness Pale or yellowish skin Irregular heartbeats Shortness of breath Dizziness or lightheadedness Chest pain Cold hands and feet Headache

4. Pathophysiological etiology

4.1. Ineffective bone marrow erythroid response to erythropoietin

4.2. surpassed production of erythropoietin

4.3. Decreased erthyrocyte life span

4.4. altered iron metabolism

5. Inflammation:

5.1. During inflammation, neutrophils release lactoferin which has a high affinity in bonding to iron, leading to a failure in erythropoiesis due to the supposed decrease in iron availability

5.1.1. Diminished number of responsive cells

5.2. Kidneys greatly affected: circulating immune complexes activate secondary immune responses.

6. Defined: Results from decresed erthyropoiesis in individuals with chronic systemic disease or inflammation