Anemia of chronic disease overview: Difference between revisions
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==Classification== | ==Classification== | ||
There is no established classification of anemia of chronic disease. | |||
==Pathophysiology== | ==Pathophysiology== | ||
Inflammatory [[cytokines]] induce increased amounts of [[hepcidin]] by the liver. Hepcidin blocks [[ferroportin]] from releasing iron from the body stores. Inflammatory [[cytokines]] also decrease [[ferroportin]] expression and stops [[erythropoiesis]] by increasing bone marrow [[erythropoietin]] resistance. Apart from [[iron]] sequestration, [[white blood cells]] production is promoted by inflammatory [[cytokines]]. [[Bone marrow]] [[stem cells]]<nowiki/>produce both [[red blood cells]] and [[white blood cells]] [[Stem cells|cells]]. Therefore, the upregulation of [[white blood cells]] causes fewer [[stem cells]] to differentiate into [[red blood cells]]. This may also have a role in inhibition of [[erythropoiesis]] ,even when [[erythropoietin]] levels are normal, and aside from the effects of [[hepcidin]]. | |||
==Causes== | ==Causes== | ||
Conditions that can lead to anemia of chronic disease include autoimmune disorders, such as [[Crohn's disease]], [[systemic lupus erythematosus]], [[rheumatoid arthritis]], and [[ulcerative colitis]], [[Cancer]] including [[lymphoma]] and [[Hodgkin's disease]], c[[Chronic kidney disease|hronic kidney disease,]] liver [[cirrhosis]], long-term [[infections]], such as [[bacterial endocarditis]], [[osteomyelitis]] (bone infection), [[HIV]]/[[AIDS]], [[hepatitis B]] or [[hepatitis C]], less production of [[erythropoietin]] (EPO) by [[kidneys]], resistance of [[bone marrow]] to EPO., decreased half life of [[red blood cells]], hospitalized for severe acute [[infections]], [[trauma]], or other conditions that cause [[inflammation]] and a[[Aging|ging]] process may cause [[inflammation]] and [[anemia]]. | |||
==Differentiating Xyz from Other Diseases== | ==Differentiating Xyz from Other Diseases== | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
30 to 60 percent of patients in [[rheumatoid arthritis]] patients have [[anemia]]. More than 30 of [[cancer]] patients have [[anemia]]. The rate reached 63 percent. In elderly patients, about one third of the cases of [[anemia]] are ACD. | |||
==Risk Factors== | ==Risk Factors== | ||
Risk factors for anemia of chronic disease include [[autoimmune disorders]], chronic infection, [[trauma]], major [[surgery]], [[malignancy]], [[HIV]] infection, rheumatologic disorders, [[inflammatory bowel disease]], [[castleman disease]], [[heart failure]], older adults, [[renal insufficiency]] and [[chronic obstructive pulmonary disease]]. | |||
==Screening== | ==Screening== | ||
There is insufficient evidence to recommend routine screening for anemia of chronic disease. | |||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
Revision as of 17:09, 2 October 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Historical Perspective
Classification
There is no established classification of anemia of chronic disease.
Pathophysiology
Inflammatory cytokines induce increased amounts of hepcidin by the liver. Hepcidin blocks ferroportin from releasing iron from the body stores. Inflammatory cytokines also decrease ferroportin expression and stops erythropoiesis by increasing bone marrow erythropoietin resistance. Apart from iron sequestration, white blood cells production is promoted by inflammatory cytokines. Bone marrow stem cellsproduce both red blood cells and white blood cells cells. Therefore, the upregulation of white blood cells causes fewer stem cells to differentiate into red blood cells. This may also have a role in inhibition of erythropoiesis ,even when erythropoietin levels are normal, and aside from the effects of hepcidin.
Causes
Conditions that can lead to anemia of chronic disease include autoimmune disorders, such as Crohn's disease, systemic lupus erythematosus, rheumatoid arthritis, and ulcerative colitis, Cancer including lymphoma and Hodgkin's disease, chronic kidney disease, liver cirrhosis, long-term infections, such as bacterial endocarditis, osteomyelitis (bone infection), HIV/AIDS, hepatitis B or hepatitis C, less production of erythropoietin (EPO) by kidneys, resistance of bone marrow to EPO., decreased half life of red blood cells, hospitalized for severe acute infections, trauma, or other conditions that cause inflammation and aging process may cause inflammation and anemia.
Differentiating Xyz from Other Diseases
Epidemiology and Demographics
30 to 60 percent of patients in rheumatoid arthritis patients have anemia. More than 30 of cancer patients have anemia. The rate reached 63 percent. In elderly patients, about one third of the cases of anemia are ACD.
Risk Factors
Risk factors for anemia of chronic disease include autoimmune disorders, chronic infection, trauma, major surgery, malignancy, HIV infection, rheumatologic disorders, inflammatory bowel disease, castleman disease, heart failure, older adults, renal insufficiency and chronic obstructive pulmonary disease.
Screening
There is insufficient evidence to recommend routine screening for anemia of chronic disease.