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Pathogenesis and treatment of the anemia of chronic disease
1Department of Medicine, Department of Veterans Affairs Medical Center, Nashville, Tennessee.
Insights
Anemia of chronic disease, a common condition, stems from underproduction of red blood cells. Recent breakthroughs are improving understanding and treatment of this frequent anemia.
Area of Science:
- Hematology
- Internal Medicine
- Pathophysiology
Background:
- Anemia of chronic disease (ACD) is a frequent complication of chronic inflammatory, infectious, or neoplastic disorders.
- It is the second most common type of anemia, following iron-deficiency anemia.
- ACD is characterized by reduced red blood cell production, typically presenting as normochromic, normocytic anemia, though microcytic, hypochromic forms occur.
Purpose of the Study:
- To review recent advances in understanding the pathogenesis of anemia of chronic disease.
- To discuss emerging treatment strategies for this condition.
Main Methods:
- Literature review of recent research on anemia of chronic disease.
- Analysis of current understanding of ACD pathogenesis.
- Evaluation of novel therapeutic approaches.
Main Results:
- Major advances have been made in elucidating the mechanisms underlying ACD.
- New insights into the pathogenesis are paving the way for improved treatment options.
- The review highlights key findings in understanding and managing ACD.
Conclusions:
- Significant progress has been achieved in understanding the pathogenesis of anemia of chronic disease.
- These advances offer promising avenues for developing more effective treatments.
- Further research is ongoing to fully address the challenges posed by ACD.
Abstract:
The anemia of chronic disease may be viewed simply as the anemia that accompanies chronic inflammatory, infectious, or neoplastic disorders. Because these conditions are very common, the anemia of chronic disease is one of the most frequent anemias encountered, and is only second in incidence to iron-deficiency anemia. The anemia of chronic disease is primarily an anemia due to underproduction of red cells, with low reticulocyte production, and is most often a normochromic, normocytic anemia. However, in 30% to 50% of patients, the red cells are hypochromic and microcytic and, most often, the serum iron, total iron-binding capacity, and transferrin saturation are reduced in the presence of adequate iron stores. Although the differential diagnosis includes other underproduction anemias, such as those caused by vitamin and mineral deficiencies, renal failure, endocrinopathies, and myelodysplasia, it generally is easily distinguished from these conditions. Nevertheless, an understanding of the pathogenesis of this condition, as well as a means of alleviating the anemia when the chronic disorder persists, has remained elusive. Recently, major advances have occurred toward understanding the pathogenesis of the anemia of chronic disease and its treatment, and these advances are reviewed.