Merck Manual

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Anemia of Chronic Disease

(Anemia of Chronic Inflammation)

By

Evan M. Braunstein

, MD, PhD, Johns Hopkins University School of Medicine

Last full review/revision Jul 2022| Content last modified Jul 2022
CLICK HERE FOR THE PROFESSIONAL VERSION

In anemia of chronic disease, inflammation caused by a chronic disorder slows the production of red blood cells and sometimes decreases survival of red blood cells.

A chronic disease is one that lasts for 3 months or longer. Worldwide, anemia of chronic disease is the second most common type of anemia.

  • Suppression of the production of red blood cells in the bone marrow

  • Decrease in the lifespan of red blood cells

  • Problems with how the body uses iron

Suppression of red blood cell production is usually not severe, so anemia develops slowly and is evident only after time.

When there is a problem with how the body uses iron, the bone marrow is unable to use stored iron to create new red blood cells.

Because anemia of chronic disease develops slowly and is generally mild, it usually causes few or no symptoms. When symptoms (for example, fatigue, weakness, or paleness) do occur, they usually result from the disease causing the anemia rather than from the anemia itself.

Diagnosis of Anemia of Chronic Disease

  • Blood tests

There are no specific laboratory tests to diagnose anemia of chronic disease, so the diagnosis is typically made by excluding other causes of anemia. In people who are diagnosed with anemia of chronic disease, doctors may do blood tests to diagnose the disorder causing the anemia.

Treatment of Anemia of Chronic Disease

  • Treatment of the disorder causing anemia

  • Sometimes drugs to stimulate red blood cell production

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. Iron supplements are usually given when using erythropoietin or darbepoietin to ensure the body reacts appropriately to these drugs. Drugs that stimulate red blood cell production (by stimulating erythropoietin, the signal that triggers such production) are not as helpful unless iron stores are adequate.

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