Anemia of Chronic Disease
Also known as anemia of inflammation.
Normocytic, normochromic anemia. Association with inflammatory diseases, malignancy, infections, and chronic medical illness.
Not a problem with iron absorption, but a problem with the distribution of iron in the body.
Is a glycoprotein hormone that controls erythropoiesis, or red blood cell production. It is a cytokine for erythrocyte precursors in the bone marrow.
Produced in the kidney in response to hypoxia.
An acute phase reactant produced by the liver in response to cytokines.
A protein that is a key regulator of the entry of iron into the circulation. In states in which the hepcidin level is abnormally high (such as inflammation), serum iron falls due to iron trapping within macrophages.
A very important test to order when assessing for anemia of chronic disease. With a low amount of hemoglobin, you would expect the reticulocyte count to be elevated. If it is not elevated, then there lies a problem with the production of red blood cells.
Ferritin levels may also be high.
Expected Lab Results - Fe Deficiency
Expected Lab Results - Normal
Expected Lab Results - ACD
Androgens and RBC Production
Androgens increase RBC production.
Estrogens and RBC Production
Estrogens decrease RBC production.
Women typically have fewer RBC than men.
Anemia of Pregnancy
1. Physiologic (diluted by volume)
2. Iron deficiency
3. Folic acid deficiency
(2 and 3 are correctable through multivitamins)