Anemia of Chronic Disease

Anemia of Chronic Disease is a common condition where the body has a lower than normal number of red blood cells due to long-lasting illnesses. It mainly affects the blood and immune systems, causing symptoms like fatigue and weakness because the blood cannot carry enough oxygen to the body's tissues. This anemia often occurs in people with chronic infections, autoimmune diseases, or cancer. The body’s response to ongoing inflammation changes how iron is used and stored, which limits red blood cell production. Although it is not caused by a lack of iron intake, the iron is trapped in storage sites and unavailable for making new red blood cells. This condition is important because it can worsen the overall health and quality of life in people with chronic diseases.

Anemia of Chronic Disease (ACD) is a normocytic, normochromic anemia characterized by impaired iron utilization and decreased erythropoiesis in the setting of chronic inflammation. It is caused by increased production of hepcidin, a liver-derived peptide that inhibits iron release from macrophages and decreases intestinal iron absorption, leading to functional iron deficiency despite adequate or increased iron stores. The underlying chronic inflammatory states include infections, autoimmune disorders, malignancies, and chronic kidney disease. ACD is clinically significant because it contributes to morbidity by exacerbating fatigue and reducing oxygen delivery to tissues. Laboratory findings typically show low serum iron, low total iron-binding capacity (TIBC), normal or increased ferritin (reflecting iron sequestration), and low reticulocyte count. The anemia is usually mild to moderate and develops over weeks to months.