Share this page

Health Library

Anemia of Chronic Disease(Anemia of Inflammation; Hypoferremia of Inflammatory Disease; ACD)
Definition

Certain long term medical conditions, such as cancer and infectious and inflammatory diseases can cause anemia. Anemia is a low level of healthy red blood cells (RBCs). RBCs carry oxygen from the lungs to the rest of the body. When red blood cells are low, the body does not get enough oxygen. This can cause symptoms such as fatigue, pale skin, or irregular heartbeat.

Hemoglobin


Copyright © Nucleus Medical Media, Inc.

Causes

Certain illnesses will prompt your body to limit how much iron is freely available. This will prevent the infection or cancer from using the iron to grow. Unfortunately, iron is also needed to make healthy RBCs. Over time, this will lead to fewer new red blood cells.

Long term illnesses that can lead to anemia, include

Risk Factors

Anyone of any age with a chronic inflammatory or infectious disease may be at risk for ACD, but the elderly are among those at highest risk.

Symptoms

ACD usually develops slowly, producing few or no symptoms. When symptoms do occur, they are usually mild. Symptoms include:

  • Pale complexion, lightheadedness, fatigue, and rapid heartbeat
  • Fever
Diagnosis

You will be asked about your symptoms and medical history, particularly any history of chronic inflammatory or infectious disease or cancer. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

Treatment

With ACD, if the underlying disease causing it is found and treated, the anemia may improve or clear on its own. Iron supplements and vitamins are generally not effective.

For severe cases of ACD, blood transfusions may be necessary. Another treatment is to give erythropoiesis-stimulating agents (ESAs), which help stimulate growth of new red blood cells. These drugs do have risks that are important to consider before using them. There is some evidence that ESAs may shorten survival in cancer patients.

Prevention

If you have a chronic medical condition, continue prescribed treatment and maintain regular visits with your doctor.

RESOURCES:

Iron Disorders Institute
http://www.irondisorders.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Health Canada
http://www.hc-sc.gc.ca

References:

Beutler E. Unlocking the mysteries of iron homeostasis and of the anemia of chronic disease: is hepcidin the key? Blood. 2003;102:775.

Weiss G, Goodnough, LT. Anemia of chronic disease. NEJM. 2005;352:1011-1023.

What is anemia? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/anemia/. Updated May 18, 2012. Accessed August 19, 2014.

3/12/2008 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Bennett CL, Silver SM, Djulbegovic B, et al. Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer-associated anemia. JAMA. 2008;299:914-924.

9/2/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Bohlius J, Schmidlin K, Brillant C, et al. Erythropoietin or Darbepoetin for patients with cancer—meta-analysis based on individual patient data. Cochrane Database Syst Rev. 2009;(3):CD007303.



Last reviewed August 2014 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Baptist Flame

Health Library

Find A Doctor

Services

Locations

Baptist Medical Clinic

Patients & Visitors

Learn

Contact Us

Physician Tools

Careers at Baptist

Employee Links

Online Services

At Baptist Health Systems

At Baptist Medical Center

close ×