Anemia of chronic disease

Haema 2013; 4(1):23-30

by Maria Ximeri, Stavroula Kiriakaki, Charalampos Pontikoglou

Hematology Clinic, University Hospital of Heraklion, University School of Medicine, Crete, Greece

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Anemia of chronic disease (ACD) is the second most common form of anemia, seen in a variety of inflammatory, infective and malignant diseases. ACD is usually mild, normocytic and normochromic anemia and is a comorbid condition, associated with poor outcomes. Changes in iron homeostasis, reduced EPO production, blunted marrow erythroid response to EPO and decreased erythrocyte life span are the main pathogenic features of ACD. Hepcidin is a key regulator of iron homeostasis, while the effects of cytokines at the various stages of erythropoiesis and turnover have also been studied. Diagnosis requires exclusion of other conditions leading to anemia. Treatment is directed mainly at the underlying disease, when this is possible. Better understanding of the pathogenesis of ACD may lead to development of more specific treatments targeting the molecular pathways involved.