Anemia, Chronic Disease

Christopher Lin-Brande, MD and Jason C. McCarthy, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Otherwise known as anemia of chronic inflammation

  • During chronic systemic infection, inflammation, or malignancy, the production of proinflammatory mediators causes inhibition of eryt...

DIAGNOSIS

HISTORY

  • ACD is often discovered incidentally on routine CBC with differential.

  • ACD presents with the underlying causative infectious, inflammatory, or malignant process without any source of o...

TREATMENT

GENERAL MEASURES

  • Primary management should focus on the underlying cause of ACD (1).

    • Treatment of the primary disease will generally restore Hgb back to baseline.

  • In cases where primary treat...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Referral to a hematologist is not always warranted. 

Patient Monitoring

  • Hgb should not be increased >11 to 12 g/dL because normalization of Hgb has been associat...

REFERENCES

1 Gangat N, Wolanskyj AP. Anemia of chronic disease. Semin Hematol.  2013;50(3):232–238.  [View Abstract]
2 Thomas DW, Hinchliffe RF, Briggs C, et al; for British Committee for Stand...

ADDITIONAL READING

  • Besarab A, Bolton WK, Browne JK, et al. The effects of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoetin. N E...

SEE ALSO

Anemia, Iron Deficiency; Iron Studies; Microcytic Anemia 

CODES

ICD10

  • D63.8 Anemia in other chronic diseases classified elsewhere

  • D63.0 Anemia in neoplastic disease

  • D63.1 Anemia in chronic kidney disease

ICD9

  • 285.29 Anemia of other chronic disease

  • 285.22 Anemia in...

CLINICAL PEARLS

  • ACD is the second most common anemia seen clinically.

  • One of the most common diagnostic problems is making the distinction between ACD, IDA, and combined ACD + IDA.

    • Iron level is usual...

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