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Disorders of Iron
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Search by Disorder
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| Iron Related Issues
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| Anemia of Chronic Disease
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Anemia of Chronic Disease (ACD) is a condition of impaired iron utilization where functional iron (hemoglobin) is low but tissue iron (such as in storage) is normal or high. ACD is seen in a wide range of chronic malignant, autoimmune, leukemic, inflammatory, and infectious disease conditions.
In rheumatoid arthritis there is frequently co-existence of ACD and iron deficiency anemia resulting from gastrointestinal bleeding due to drug therapy. ACD, also known as hypoferremia of inflammatory disease and anemia of inflammation, is often diagnosed as mild iron deficiency anemia.
Risk Group: The elderly are among the highest risk group for anemia of chronic disease, but anyone regardless of age who has chronic inflammatory disease such as rheumatoid arthritis or infection can be at risk.
Symptoms:
Anemia of chronic disease can be present in numerous situations associated with inflammation, infection, and cancer. When infection, fever--even mild, or history of cancer or suspicion of cancer is present with low hemoglobin but elevated ferritin, anemia of chronic disease should be considered.
Detection
When ACD is suspect fasting serum iron will be low, serum ferritin elevated, transferrin iron saturation percentage low, total iron binding capacity low, transferrin low and the serum transferrin receptor normal.
Treatment
The cause of anemia will dictate treatment. Once inflammation, infection or presence of pathogen is identified and treated, anemia may be resolved. In cases where cancer is the cause of anemia, cancer treatment and therapy take priority over removal of iron that has resulted from transfusion or infusion.
Supplementation with iron for those with ACD is not warranted until the underlying cause of disease is cured. Harmful pathogen are nourished by iron and cancer cells require iron to grow and proliferate.
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