Anemias of chronic disease in the aged: diagnosis and treatment

The classic anemia of chronic disease is sideropenic and is the result of subacute or chronic inflammatory illness, including malignancy. Nonsideropenic anemias, by contrast, are the result of failure of vital organs or endocrine glands. The pathophysiology of these anemias is multifactorial, but underlying all of them is absolute or relative hypoerythropoietinemia. Therapy consists of treating the underlying illness and, if necessary, providing packed red blood cell transfusions. Some patients will respond to recombinant erythropoietin injections, which have been shown to result in improved hemoglobins and hematocrits and an enhanced quality of life.