Anemia of chronic illness (ACD) is a type of anemia that is usually observed in people suffering from chronic illnesses such as rheumatoid arthritis, diabetes, heart diseases, inflammatory bowel disease as well as severe trauma and chronic kidney disease (Colbert, 2018). Anemia of chronic illness is characterized by various pathognomic features; low levels of erythropoietin, reduced iron stores, a reduced lifespan of Red Blood cells from the usual 120 days.
There are various mechanisms that are thought to cause anemia of chronic illness. The most common mechanism is a decrease in the absortption of iron from various sites of the body. Iron is the major raw material for the synthesis of hemoglobin and therefore if the uptake is reduced, this ultimately results in reduced synthesis hence anemia. Another mechanism that this anemia develops is through destruction of precursors of red blood cells by various cytokines for example IL-6, IL-1 and tumor necrosis factor (Colbert, 2018). Destruction of immature red blood cells means that few red blood cells reach maturity hence a decrease in circulating RBCs hence anemia. Cytokines are also through to destroy erythropoietin receptors on progenitor cells which means that they are not stimulated to produce RBCs which explains the deficiency. Another mechanism that this anemia is thought to occur is through increased level of Hepcidin which results in reduced absorption of iron from the gut.
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Anemia of chronic illness manifests as the other types of anemia only that in the case of chronic anemia, the symptoms are mixed with symptoms of the chronic illness that the patient has. Signs and symptoms include; easy fatigability, dizziness, weakness, syncope, palpitations.
ACD is caused purely by existing chronic comorbidities such as rheumatoid arthritis, inflammatory bowel disease, and chronic heart diseases such as heart failure among others. Modifiable risk factors for ACD include; obesity, alcohol use, tobacco use, physical inactivity as these are known to contribute to most of the common chronic diseases. Non-modifiable risk factors such as age, race, sex determine the susceptibility of individuals to chronic illnesses and hence the prevalence of ACD. For example, as one ages, the risk of chronic illnesses such as malignancies increase which directly increases the risk of ACD.
References
Colbert. (2018, November 21). Medscape. Retrieved from Mechanism of Anemia of Chronic Disease: https://emedicine.medscape.com/article/1389854-overview#a2
Madu, A. J., & Ughasoro, M. D. (2016). Anaemia of Chronic Disease: An In-Depth Review. Medical Principles and Practice , 26 (1), 1–9. doi: 10.1159/000452104
