Anemia in older ages in both men and women is a frequent finding, and its impact on morbidity and…
mortality of these persons has not been adequately appreciated.
According to the World Health Organization (WHO) as a anemia we define the state of the blood in which the haemoglobin value is lower than 13.5 g% in men and lower than 12g% in women.
Anemia of chronic disease also called anemia of chronic inflammation is initially associated with infectious, inflammatory and neoplastic diseases. Later, however, it was observed that anemia of chronic disease also occurs in other situations such as in severe trauma, cardiovascular diseases, diabetes mellitus, hyper/hypothyroidism and chronic renal failure.
The most common diseases that can be accompanied by anemia of chronic disease is:
1) infections (HIV, tuberculosis, fungal infections, malaria, osteomyelitis, chronic abscesses, sepsis),
2) inflammatory diseases (e.x. rheumatoid arthritis, systemic vasculitides, inflammatory diseases of intestine, sarcoidosis), and
3) malignant neoplasms of solid organs, lymphomas and multiple myeloma.
The diagnosis of anemia of chronic disease is as a rule by exclusion. It is usually οÏθοκυτταÏική, οÏθόχÏωμη, but at the rate of 25% can be microcellular, especially when there is iron deficiency due to concomitant blood loss. It is usually mild to moderate and often requires examination of the bone marrow in order to rule out other causes for the existence of anemia. By the testing laboratory markers such as the MCV and MCHC are usually normal, while ferritin increased. The σιδηÏοδεσμευτική capacity (TBIC) is reduced and the bone marrow shows hemosiderin with normal cellularity and increased plasma cells.
Anemia of chronic disease is usually οÏθόχÏωμη, and does not affect other cell lines. The differential diagnosis should include:
(a) chronic iron deficiency,
(b) the θαλασσαιμικά syndromes,
(c) the σιδηÏοβλαστικÎÏ‚ variations of μυελοδυσπλαστικών syndromes,
(d) the φαÏμακογενής marrow suppression. The measurement of iron, transferrin and φεÏιτίνης can not confirm the diagnosis. The patient’s history (acute or chronic inflammatory disease) and elements, not to mention loss of blood, suggest that anemia.
The inflammation, in general, is a pathological process, which can lead to anemia. Associated with inflammation cytokines, as mentioned induce the production of acute phase proteins, which reflect the activity of inflammation. The absence of a response of precursor forms of erythrocytes in the stimulus of erythropoietin, which is reduced, and the reduced mobilization of iron from the macrophages were mainly responsible for the anemia of inflammation.
The main haematological abnormalities that occur in chronic inflammatory rheumatic diseases is anemia of diverse etiology, disorders of leukocytes, platelets and the clotting and haematological malignant diseases. The chronic inflammatory rheumatic diseases associated with anemia of chronic disease is mainly rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), polymyositis, polyarteritis nodosa and idiopathic inflammatory bowel diseases (Crohn’s disease and ulcerative colitis).
Symptoms caused by anemia.
Payment
Dizziness
Headache
Sleep disorders
Cold extremities
Anorexia
Inability to concentrate
Palpitations and shortness of breath after slight fatigue
Depression
Treatment of anemia of chronic disease
It has been reported that the anemia in general should be considered a symptom of underlying disease, and in most times it does not make sense ανάταξή without addressing the factors that caused it.
In some cases the reduction of the anemia without treating the underlying disease is considered a serious medical mistake. A typical example in this respect is the development of iron deficiency anemia of neoplasm of the colon (particularly anion). The administration of iron in posthaemorrhagic this anemia only, without investigating surgery deprives the patient of the possibility of full healing.
For patients with anemia of chronic disease, the administration of erythropoietin with co-administration of iron is the treatment of choice for selected patients of this group. In patients with chronic renal insufficiency the administration of erythropoietin with iron has been established for almost ten years and have been issued on the guidelines. For patients with chronic inflammation, the administration of erythropoietin is an option, but it has not been established, nor are there any guidelines. For patients with chronic heart failure in a recent study from the National Heart and Lung Institute, London, reported that in patients with chronic heart failure, low hemoglobin is associated with functional limitations and reduction of anemia at prices higher than 11.5 gr with erythropoietin and iron has resulted in the improvement of the patient, at least in the short term.
Source
Anemia in older people (the elderly) is common. With what diseases is related to the anemia of chronic disease?
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