Anemia of chronic diseaseAnemia of inflammation; Inflammatory anemia; AOCD; ACD
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia.
Anemia of chronic disease (ACD) is anemia that is found in people with certain long-term (chronic) medical conditions that involve inflammation.
Anemia is a lower-than-normal number of red blood cells in the blood. ACD is a common cause of anemia. Some conditions that can lead to ACD include:
- Autoimmune disorders, such as Crohn disease, systemic lupus erythematosus, rheumatoid arthritis, and ulcerative colitis
- Cancer, including lymphoma and Hodgkin disease
- Long-term infections, such as bacterial endocarditis, osteomyelitis (bone infection), HIV/AIDS, lung abscess, hepatitis B or hepatitis C
Anemia of chronic disease is often mild. You may not notice any symptoms.
When symptoms occur, they may include:
- Feeling weak or tired
- Shortness of breath
Exams and Tests
The health care provider will perform a physical exam.
Anemia may be the first symptom of a serious illness, so finding its cause is very important.
Tests that may be done to diagnose anemia or rule out other causes include:
- Complete blood count
- Reticulocyte count
- Serum ferritin level
- Serum iron level
- C-reactive protein level
- Erythrocyte sedimentation rate
- Bone marrow examination (in rare cases to rule out cancer)
Anemia is often mild enough that it does not need treatment. It may get better when the disease that is causing it is treated.
More severe anemia, such as that caused by chronic kidney disease, cancer, or HIV/AIDS may require:
- Blood transfusion
- Erythropoietin, a hormone produced by the kidneys, given as a shot
The anemia will improve when the disease that is causing it is treated.
Discomfort from symptoms is the main complication in most cases. Anemia may lead to a higher risk for death in people with heart failure.
When to Contact a Medical Professional
Call your provider if you have a long-term (chronic) disorder and you develop symptoms of anemia.
Means RT. Approach to the anemias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 149.
Nayak L, Gardner LB, Little JA. Anemia of chronic diseases. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 37.
Review Date: 2/6/2020
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.