Anemia of chronic inflammation

Anemia of Chronic Inflammation (ACI), also known as Anemia of Chronic Disease (ACD), is a type of anemia that commonly occurs in individuals with chronic illnesses such as infections, autoimmune diseases, and cancers. It is characterized by a decrease in the production of red blood cells, leading to a reduction in the body's ability to carry oxygen to its tissues.

Etiology

ACI is typically caused by chronic diseases that lead to prolonged inflammation in the body. These can include rheumatoid arthritis, systemic lupus erythematosus, HIV/AIDS, tuberculosis, and various types of cancer. The inflammation caused by these diseases leads to an increase in the production of certain proteins, such as hepcidin, which can inhibit the production of red blood cells and lead to anemia.

Pathophysiology

The pathophysiology of ACI involves a complex interaction between the immune system, iron metabolism, and red blood cell production. Chronic inflammation leads to an increase in the production of cytokines, which can affect the body's iron metabolism by increasing the production of hepcidin. Hepcidin inhibits the release of iron from macrophages and the absorption of iron from the gut, leading to a decrease in the availability of iron for red blood cell production.

Clinical Features

The clinical features of ACI can vary depending on the underlying disease causing the inflammation. However, common symptoms can include fatigue, weakness, pallor, and shortness of breath. In severe cases, ACI can lead to heart failure due to the increased workload on the heart caused by the lack of oxygen-carrying capacity in the blood.

Diagnosis

The diagnosis of ACI is typically made based on the presence of anemia in a patient with a known chronic inflammatory disease. Laboratory tests may show low levels of hemoglobin, a protein in red blood cells that carries oxygen, and low levels of serum iron. However, the levels of ferritin, a protein that stores iron in the body, may be normal or elevated, reflecting the body's attempt to withhold iron from the pathogens causing the inflammation.

Treatment

The treatment of ACI primarily involves managing the underlying disease causing the inflammation. This can involve the use of anti-inflammatory drugs, immunosuppressants, or antibiotics, depending on the cause of the inflammation. In some cases, iron supplementation may be used to increase the availability of iron for red blood cell production. However, this is typically only effective if the inflammation can be adequately controlled.

See Also

• Anemia
• Chronic disease
• Inflammation
• Iron deficiency anemia