Anemia of chronic disease (ACD), also known as anemia of inflammation, is a type of anemia that is commonly observed in individuals with chronic inflammatory conditions such as rheumatoid arthritis, chronic infections, autoimmune diseases, cancer, and other long-term illnesses. It’s characterized by a decrease in the production of red blood cells (RBCs) and hemoglobin, resulting in a reduced capacity of the blood to carry oxygen to tissues.
The exact mechanism behind ACD is complex and involves multiple factors, including:
- Interference with iron metabolism: Chronic inflammation leads to increased levels of hepcidin, a hormone that regulates iron metabolism. Elevated hepcidin levels can inhibit the release of iron from storage sites in the body, reducing the availability of iron for red blood cell production.
- Suppression of erythropoiesis: Inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) can suppress the production of erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow.
- Shortened red blood cell lifespan: Chronic inflammation can shorten the lifespan of red blood cells, leading to their premature destruction and a decrease in overall red blood cell count.
Symptoms of anemia of chronic disease may include fatigue, weakness, shortness of breath, pale skin, and dizziness. Treatment typically focuses on managing the underlying chronic condition and may involve iron supplementation, erythropoiesis-stimulating agents (such as recombinant erythropoietin), or blood transfusions in severe cases.
It’s important for individuals with chronic inflammatory diseases to work closely with their healthcare providers to monitor and manage their anemia, as untreated anemia can worsen the symptoms and overall health outcomes of the underlying condition.