What is Anaemia of Chronic Disease? A Patient's Guide

Anaemia of chronic disease (ACD) is a type of anaemia that occurs in people with certain long-term medical conditions such as chronic infections, autoimmune diseases, or cancer. Anaemia is a condition where your blood has a lower than normal number of red blood cells or less haemoglobin, the protein in red blood cells that carries oxygen. Understanding ACD is important because it can affect your quality of life and may require specific management strategies.

What causes Anaemia of Chronic Disease?

Anaemia of chronic disease is primarily caused by underlying health conditions that interfere with the production and lifespan of red blood cells. These conditions often involve inflammation, which is the body's response to infection or injury. Inflammation can lead to reduced production of erythropoietin, a hormone made by the kidneys that stimulates red blood cell production. Additionally, inflammation can cause the body to hold onto iron, making it less available for making new red blood cells. Common conditions associated with ACD include chronic kidney disease, rheumatoid arthritis, and inflammatory bowel disease.

Symptoms of Anaemia of Chronic Disease

The symptoms of ACD are similar to those of other types of anaemia and can include fatigue, weakness, pale skin, and shortness of breath. Because these symptoms are common and can be caused by various conditions, it's important to have blood tests to determine the specific type of anaemia. In ACD, laboratory tests might show normal or increased levels of ferritin (a protein that stores iron) but low levels of transferrin (a protein that transports iron), indicating that iron is not being properly utilized.

Diagnosing Anaemia of Chronic Disease

Diagnosis of ACD involves a combination of medical history, physical examination, and laboratory tests. Blood tests will typically show a low haemoglobin level, which is the hallmark of anaemia. Other tests may include measuring levels of iron, ferritin, and transferrin, as well as markers of inflammation such as C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR). It's important to differentiate ACD from iron-deficiency anaemia, as the treatment approaches differ.

Treatment options for Anaemia of Chronic Disease

The primary focus in managing ACD is treating the underlying condition causing the inflammation. This may involve medications to control inflammation or other therapies specific to the chronic disease. In some cases, doctors might prescribe erythropoiesis-stimulating agents (ESAs), which are drugs that help stimulate the production of red blood cells. Iron supplementation is generally not effective for ACD unless there is a concurrent iron deficiency.

Frequently asked questions

What is the difference between anaemia of chronic disease and iron-deficiency anaemia?
While both conditions involve low red blood cell counts, iron-deficiency anaemia is primarily caused by a lack of iron, whereas ACD is caused by chronic inflammation and the body's altered iron metabolism.

Can anaemia of chronic disease be cured?
ACD is typically managed rather than cured, as it is often linked to a chronic underlying condition. Treatment focuses on managing the underlying disease and symptoms of anaemia.

Is anaemia of chronic disease common?
Yes, ACD is one of the most common types of anaemia, especially among individuals with chronic illnesses.

When to see a doctor

If you experience symptoms of anaemia such as persistent fatigue, weakness, or shortness of breath, it's important to consult a healthcare provider. They can perform the necessary tests to determine the cause of your symptoms and develop an appropriate treatment plan. Additionally, if you have a known chronic condition and notice a worsening of symptoms, it is advisable to seek medical attention.

This article provides information about anaemia of chronic disease and is not a substitute for professional medical advice. Always consult your healthcare provider for personal medical guidance.