Anemia of chronic diseases

Abstract

Anemia of chronic diseases (ACD) is a pathological process that develops in patients with systemic inflammation in a wide range of diseases of both infectious and non-infectious origin. ACD is the second most common disease in the world after iron deficiency anemia (IDA) and is a factor that aggravates the course of the underlying disease and increases mortality. Pathophysiologically, ACD is a complex multifactorial process and includes 3 main development mechanisms: an increase in the production of hepcidin, a decrease in the formation of erythropoietin and inhibition of normal erythropoiesis in the bone marrow. These processes are triggered by pro-inflammatory cytokines. Special attention in the article is paid to the universal humoral regulator of iron metabolism – hepcidin. For a doctor of any specialty it is important to identify ACD, conduct a differential diagnosis that allows one to distinguish ACD from other types of anemia (including iron deficiency), establish a possible combination of IDA and ACD, since different types of anemia require their own therapeutic approaches. The patient’s prognosis will depend on the correct treatment. In order to verify ACD a thorough search for the underlying disease is carried out, СBC indicators and iron metabolism indicators are assessed. The basis of the therapeutic approach to the treatment of ACD is the treatment of the underlying disease. Therapy for this type of anemia includes the use of iron preparations, erythropoietin and replacement therapy with blood components.