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Anemia of Inflammation
(Anemia of Chronic Disease; Hypoferremia of Inflammatory Disease; ACD)
Certain long-term medical conditions can cause anemia. Anemia is a low level of healthy red blood cells (RBCs). RBCs carry oxygen from the lungs to the rest of the body. When red blood cells are low, the body does not get enough oxygen.
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Anemia has several causes, but some may be unknown. Factors that play into anemia include:
- Shortened lifespan of red blood cells
- The body is not making enough new red blood cells
- Lower release of a hormone that stimulates the body to make red cells
- Problems with use of iron within the body
Long-term illnesses that can lead to anemia, include:
- Chronic infections, such as tuberculosis, lung abscess, and subacute endocarditis
- Noninfectious inflammatory diseases, such as rheumatoid arthritis, osteomyelitis, systemic lupus erythematosus, and inflammatory bowel disease
- Common childhood infections, including ear infections and urinary tract infections
- Heart failure, thyroid disease, and kidney failure
- Cancer, particularly Hodgkin disease, lung cancer, and breast cancer
Anyone with one of the conditions listed above may be at risk. There is a higher risk for it among the elderly.
Anemia often develops slowly. There may be few or no symptoms. Most symptoms are mild but may include:
- Pale complexion
- Rapid heartbeat
You will be asked about your symptoms and past health. A physical exam will be done. Blood tests will show how many RBCs you have and how healthy they are. A diagnosis can be made based on blood tests and your health history.
Anemia may improve if the underlying disease is treated.
Blood transfusions may be needed if the anemia is severe. It will supply healthy RBCs from a donor.
Medicine may also be used to encourage the growth of RBCs. This group of medicine is called erythropoiesis-stimulating agents (ESAs). This medicine may not be an option because of side effects. It can make some cancers worse.
It is not clear how to prevent this anemia. Managing some chronic conditions may reduce the risk of anemia.
Iron Disorders Institute
National Heart, Lung, and Blood Institute
Canadian Cancer Society
Anemia of inflammation. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/anemia-of-inflammation/ . Updated June 13, 2019. Accessed September 13, 2019.
Explore anemia. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/anemia. Updated May 18, 2012. Accessed September 13, 2019.
Ganz T. Anemia of Inflammation. N Engl J Med 2019; 381:1148-1157.
Nemeth E, Ganz T. Anemia of inflammation. Hematol Oncol Clin North Am. 2014 Aug;28(4):671-81
Weiss G, Ganz T, Goodnough LT. Anemia of inflammation. Blood. 2019 Jan 3;133(1):40-50.
- Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
- Review Date: 09/2019
- Update Date: 08/05/2020