Chronic Disease Anemia (Anemia of Inflammation)

Chronic disease anemia happens when long-lasting illnesses and inflammation reduce the body’s ability to make and use healthy red blood cells. It’s common in chronic kidney disease, autoimmune disorders, persistent infections, and some cancers.

In this guide: What is it? • Causes • Symptoms • Diagnosis • Treatment • Prevention • FAQ

What is Chronic Disease Anemia?

In this anemia, inflammation changes iron handling and slows red blood cell (RBC) production. Immune signals (especially hepcidin) trap iron in storage and block absorption, so hemoglobin drops even if iron stores aren’t truly empty.

Causes

• Chronic infections (e.g., tuberculosis, hepatitis, HIV)
• Autoimmune diseases (e.g., rheumatoid arthritis, lupus)
• Chronic kidney disease (including dialysis)
• Cancers that affect marrow or drive inflammation
• Other long-term inflammatory conditions

Symptoms

• Fatigue and weakness
• Pale or sallow skin
• Shortness of breath (especially with activity)
• Dizziness or headaches
• Reduced exercise tolerance and focus

Diagnosis

• CBC: mild–moderate anemia (low hemoglobin)
• Iron studies: ferritin often normal/high; serum iron & transferrin low
• History of a chronic inflammatory disease
• Rule out iron-, B12-, and folate-deficiency anemia

Treatment

The main goal is to treat the underlying condition. Supportive options:

• Optimize disease control to reduce inflammation
• ESAs (erythropoiesis-stimulating agents) when appropriate—especially in CKD
• Iron therapy: IV iron can work better than oral when hepcidin is high
• Blood transfusion for severe/symptomatic cases
• Nutrition: adequate protein, iron, B12, and folate

Student tip: In chronic disease anemia, ferritin (an acute-phase protein) may be normal or high, even while serum iron is low—classic pattern for exams.

Prevention & Self-Care

• Control the underlying chronic condition early and consistently
• Balanced diet and hydration; limit alcohol
• Regular follow-ups to monitor hemoglobin and iron status
• Report new or worsening fatigue, breathlessness, or paleness

Quick FAQ

Is it the same as iron-deficiency anemia?
No. Iron-deficiency comes from low intake/absorption or blood loss. Chronic disease anemia is driven by inflammation that alters iron usage and RBC production.

Can diet alone fix it?
Diet supports health, but controlling the underlying disease and inflammation is essential.

ProBiologiste tip: Compare this with iron-deficiency and vitamin-deficiency anemia to learn lab patterns (ferritin, transferrin, MCV).

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