Causes

Anemia is a lower-than-normal number of red blood cells in the blood. Certain chronic infections, inflammatory diseases, and other illnesses can affect the body's ability to produce red blood cells.

Conditions that can lead to anemia of chronic disease include:

• Autoimmune disorders, such as crohn's disease, systemic lupus erythematosus, rheumatoid arthritis, ulcerative colitis
• Cancer, particularly lymphoma and Hodgkin's disease
• Chronic kidney disease
• Liver cirrhosis
• Long-term infections, such as bacterial endocarditis, osteomyelitis (bone infection), HIV/AIDS, hepatitis B or hepatitis C

Symptoms

Anemia of chronic disease is often mild. You may not notice symptoms of anemia.

Symptoms may include:

• Feeling weak or tired
• Headache
• Paleness
• Shortness of breath

Exams and Tests

The doctor will perform a physical examination.

Because anemia may be the first symptom of a serious illness, determining its cause is very important.

Tests that may be done to diagnose anemia or rule out other causes include:

• Hemoglobin level
• Red blood count
• Reticulocyte count
• Serum ferritin
• Serum iron
• Other blood tests

Treatment

The anemia is often mild enough that it requires no treatment, and will likely get better when the disease that is causing it is treated.

The condition is rarely severe enough to require a blood transfusion.

Iron supplements may sometimes be used, but only for patients whose iron levels are low. Taking iron pills when your body does not need it can lead to serious medical problems. Always talk with your health care provider first.

For some conditions, such as chronic kidney disease, medicine called erythropoietin may be given. It stimulates your bone marrow to make more red blood cells.

Outlook (Prognosis)

The anemia will improve when the disease that is causing it is successfully treated.

Possible Complications

Discomfort from symptoms is the main complication in most cases. Anemia is associated with a higher risk of death in patients with heart failure.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have a chronic disorder and you develop symptoms of anemia.

Alternative Names

Anemia of inflammation

References

Gardner LB, Benz Jr EJ. Anemia of chronic diseases. In: Hoffman R, Benz EJ, Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 37.

Update Date: 2/28/2012

Reviewed by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital.