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Anemia, Chronic Disease

Stephanie Algenio-Anciro, MD and Breanna Gawrys, DO Reviewed 04/2024
 


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 treatm...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Hgb should not be increased >12 g/dL because normalization of Hgb has been associated with higher mortality.

  • Baseline and periodic monitoring ...

REFERENCES

1
Gangat  N, Wolanskyj  AP. Anemia of chronic disease. Semin Hematol.  2013; 50(3): 232– 238.  [View Abstract]
2
Weiss G, Ganz T, Goodnough L. ...

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 hemod...

SEE ALSO

Anemia, Iron Deficiency 

CODES

ICD10

  • D63.1 Anemia in chronic kidney disease

  • D63.8 Anemia in other chronic diseases classified elsewhere

SNOMED

  • 234347009 Anemia of chronic disease

  • 191268006 Chronic anemia

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 usually...

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