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Anemia of Chronic Disease

(Iron-Reutilization Anemia)

by Alan E. Lichtin, MD

In anemia of chronic disease, some chronic disorder slows the production of red blood cells and sometimes decreases survival of red blood cells.

Chronic disease often leads to anemia, especially in older adults. Conditions such as infections, inflammation, and cancer suppress production of red blood cells in the bone marrow. Some conditions also decrease the lifespan of red blood cells. Suppression is usually not severe, so anemia develops slowly and is evident only after time. Problems with how the body uses iron contribute to anemia of chronic disease. Because the bone marrow is unable to use stored iron to create new red blood cells, this type of anemia is often called iron-reutilization anemia.

Because this type of anemia develops slowly and is generally mild, it usually produces few or no symptoms. When symptoms do occur, they usually result from the disease causing the anemia rather than from the anemia itself. There are no specific laboratory tests, so the diagnosis is typically made by excluding other causes.

Because no specific treatment exists for this type of anemia, doctors treat the disorder causing it. If the disorder causing the anemia does not respond to treatment, erythropoietin or darbepoietin, drugs that stimulate the bone marrow to produce red blood cells, may be given. Taking additional iron or vitamins does not help. On the rare occasion that the anemia becomes severe, transfusions may help.