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Anaemia of Chronic Disease (Clinical Presentation (Angina if there is pre…
Anaemia of Chronic Disease
Key Facts
Secondary to chronic disease
RBC's are often NORMOCYTIC but they can be MICROCYTIC, especially in rheumatoid arthritis and Crohn's
Epidemiology
The commonest anaemia in hospital patients
Occurs in individuals with chronic infections such as: TB, Crohn's, Rheumatoid arthritis
The second most common anaemia
Risk Factors
Have a chronic disease
Pathophysiology
An inadequate erythropoietin response (cytokine which increases RBC production) to anaemia
Decreased RBC survival
There is decreased release of iron from the bone marrow to developing erythroblasts (early RBC, before reticulocyte)
Diagnosis
Serum ferritin is normal or raised due to the inflammatory process
Serum soluble transferrin receptor level is normal
Serum iron and total iron-binding capacity (TIBC) are low
Blood count & film - RBC's are NORMOCYTIC or MICROCYTIC and HYPOCHROMIC (pale)
Clinical Presentation
Angina if there is pre-existing coronary disease
Anorexia
Dyspnoea and breathlessness
Intermittent claudication
Fatigue, headaches and faintness
Palpitations
Treatment
Treat underlying chronic cause
Erythropoietin is effective in raising the haemoglobin level and is used in anaemia of renal disease and inflammatory disease e.g. rheumatoid arthritis and IBD