Anemia of Chronic Disease

Anemia of Chronic Disease

Adrien Selim, MD, and Vanessa Cardy, MD

Background

• Associated with
• Neoplasms
• Chronic inflammatory diseases
• Infectious diseases
• Pathophysiology is complex and involves
• Inability to mobilize iron stores
• ↓ absorption of iron
• ↓ erythropoiesis
• ↓ red blood cell survival

Clinical Findings

• History and physical
• Findings consistent with underlying diseases and/or anemia
• Labs
• Complete blood count
• Mild-moderate anemia
• Initially normal mean corpuscular volume (MCV), then ↓ MCV
• ↓ reticulocyte count
• Fe studies (see chart below)
• Ferritin = normal to ↑
• Transferrin = ↓ 
• Serum Fe = ↓ 
• Transferrin saturation = ↓

Management

• Treat underlying cause
• Oral or parenteral iron
• Blood transfusion as needed