Anemia of Inflammation.

Area of Science:

• Hematology
• Immunology
• Pathophysiology

Background:

• Anemia of inflammation (AI), also known as anemia of chronic disease, is a prevalent condition, second only to iron deficiency anemia (IDA) globally.
• AI is characterized by iron sequestration in macrophages, leading to hypoferremia, hyperferritinemia, suppressed erythropoiesis, and reduced erythrocyte lifespan.
• Diagnosis can be challenging due to frequent co-occurrence with true iron deficiency, necessitating careful assessment of iron status and needs.

Purpose of the Study:

• To provide a comprehensive overview of anemia of inflammation (AI).
• To discuss the diagnostic challenges and therapeutic strategies for AI.
• To explore emerging treatment modalities targeting the hepcidin-ferroportin axis.

Main Methods:

• Literature review of anemia of inflammation (AI).
• Analysis of diagnostic criteria and challenges in differentiating AI from IDA.
• Evaluation of current and novel therapeutic interventions for AI.

Main Results:

• AI presents as a mild-to-moderate normocytic, normochromic, hypoproliferative anemia with reduced transferrin saturation and increased ferritin.
• Treatment of the underlying inflammatory disease is primary; iron supplementation is effective for AI+IDA but less so for AI alone.
• Erythropoiesis-stimulating agents have limited efficacy in AI, and novel therapies targeting the hepcidin-ferroportin axis are under investigation.

Conclusions:

• Anemia of inflammation requires a multifaceted approach, prioritizing treatment of the underlying cause.
• Accurate diagnosis of iron status is crucial for effective management, especially in cases co-existing with iron deficiency.
• Further research and clinical trials are needed for novel therapeutic strategies, including those modulating the hepcidin-ferroportin axis.