There are many different types ofanemia, a condition in which there is a low number of red blood cells (RBCs) or a low hemoglobin concentration in the body. Hemoglobin is an iron-rich protein in the RBCs that binds to oxygen, transporting it to tissues throughout the body.
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Anemia can develop due to nutritional deficits, blood loss, or chronic diseases.Anemia of chronic diseaseis a specific type of anemia that’s associated withinflammation.And anemia is common in people withinflammatory types of arthritis,such asrheumatoid arthritis (RA).
The types of anemia can be distinguished from each other with diagnostic tests, such as acomplete blood count. And the treatment of anemia is tailored to the type.
Symptoms of Anemia
Common symptoms associated with anemia include fatigue,shortness of breath, dizziness, rapid heartbeat, headache,feeling cold, and pale or yellowish skin.You can experience a combination of these symptoms, but you might not notice any symptoms of anemia.
Often, the condition is first detected with a blood test, especially if the anemia is mild.
Types of Anemia
Iron-deficiency anemia:The most common type of anemia, microcytic anemia (small RBCs), develops when you lack a sufficient amount of iron in your body to make normal amounts of RBCs. Typically, iron-deficiency anemia occurs due to blood loss or decreased iron absorption.
Vitamin-deficiency anemia: Low levels of vitamin B12 or folic acid in the body cause macrocytic anemia (enlarged RBCs) and low numbers of RBCs.Vitamin B12 deficiencyoften develops when this vitamin is not well-absorbed. Pernicious anemia is one of many causes of B12 deficiency.
Aplastic anemia: This rare type of anemia develops when the body stops producing sufficient numbers of red blood cells. Viral infections, exposure to toxic chemicals,autoimmune diseases, and certain drugs are among the causes.
Hemolytic anemia:Abnormal breakdown of red blood cells in the bloodstream or the spleen is usually associated withsickle cell anemia.. Other causes include an artificial heart valve, infection, or autoimmune disease.
Anemia of chronic disease: Cancer, kidney disease, liver disease, thyroid disease, and RA, can interfere with the production of red blood cells.
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Anemia of Chronic Disease vs Iron-Deficiency Anemia
Chronic inflammatory disease can cause both iron deficiencyandanemia of chronic disease.
People who have arthritis, for example, often take anonsteroidal anti-inflammatory drug (NSAID)as part of their treatment regimen. NSAIDs have been tied to an increased risk ofgastrointestinal bleeding.
If bleeding is suspected, it’s important that the source of bleeding is identified.
Autoimmune Hemolytic Anemia: Everything You Need to Know
Anemia of Chronic Disease
Anemia of chronic disease can be stable. Generally,hemoglobin levelshover in aslightly lowerthan the normal range, not typically lower than 9.5 mg/dl.
In both iron-deficiency anemia and anemia of chronic disease, serum iron is low. But there are some differences in blood tests that can help distinguish the conditions.
Total iron-binding capacity (TIBC): Transferrin, a protein that transports iron, is elevated in iron-deficiency anemia—a sign that the body needs more iron. The TIBC, an indirect measurement of transferrin, is usually high when iron stores are decreased and low when iron stores are elevated. TIBC is low or normal in anemia of chronic disease—a sign that there is enough iron but it is not readily available. In iron-deficiency anemia, TIBC is typically high, often in excess of 400 mcg/dl because iron stores are low.
Serum ferritin: This protein contains iron, and it should be low in iron deficiency anemia. Ferritin can be elevated in the presence of inflammation. With some chronic diseases, serum ferritin may be raised to normal levels, even if iron-deficiency anemia exists.
Serum transferrin receptor test: In iron-deficiency anemia, the serum transferrin receptor will be high. In anemia of chronic disease, serum transferrin receptor is usually low or on the low side of normal.
Anemia of chronic disease is not treated with iron supplementation. Additional iron can actually be harmful, depending on the underlying chronic disease.Iron supplementation may be indicated in iron-deficiency anemia, however.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Anemia of inflammation or chronic disease.American Society of Hematology.Anemia.MedlinePlus.Iron deficiency anemia.The Aplastic Anemia and MDS International Foundation.Aplastic anemia causes.John Hopkins Medicine.Hemolytic anemia.Goldstein JL, Cryer B.Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategies.Drug, Healthc Patient Saf.2015;7:31-41. doi:10.2147/DHPS.S71976Madu AJ, Ughasoro MD.Anaemia of chronic disease: an In-depth review.Med Princ Pract. 2017;26(1):1-9. doi:10.1159/000452104Cancer Therapy Advisor.Anemia of chronic disease (anemia of chronic inflammatory disease, hypoferremia of inflammation).Kell DB, Pretorius E.Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells.Metallomics. 2014;6(4):748–773. doi:10.1039/c3mt00347gYokus O, Yilmaz B, Albayrak M, Balcik OS, Helvaci MR, Sennaroglu E.The significance of serum transferrin receptor levels in the diagnosis of the coexistence of anemia of chronic disease and iron deficiency anemia.Eurasian J Med; 43(1):9-12.Merck Manual Professional Version.Anemia of chronic disease.Additional ReadingIron Disorders Institute.Anemia of chronic disease.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Anemia of inflammation or chronic disease.American Society of Hematology.Anemia.MedlinePlus.Iron deficiency anemia.The Aplastic Anemia and MDS International Foundation.Aplastic anemia causes.John Hopkins Medicine.Hemolytic anemia.Goldstein JL, Cryer B.Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategies.Drug, Healthc Patient Saf.2015;7:31-41. doi:10.2147/DHPS.S71976Madu AJ, Ughasoro MD.Anaemia of chronic disease: an In-depth review.Med Princ Pract. 2017;26(1):1-9. doi:10.1159/000452104Cancer Therapy Advisor.Anemia of chronic disease (anemia of chronic inflammatory disease, hypoferremia of inflammation).Kell DB, Pretorius E.Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells.Metallomics. 2014;6(4):748–773. doi:10.1039/c3mt00347gYokus O, Yilmaz B, Albayrak M, Balcik OS, Helvaci MR, Sennaroglu E.The significance of serum transferrin receptor levels in the diagnosis of the coexistence of anemia of chronic disease and iron deficiency anemia.Eurasian J Med; 43(1):9-12.Merck Manual Professional Version.Anemia of chronic disease.Additional ReadingIron Disorders Institute.Anemia of chronic disease.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Diabetes and Digestive and Kidney Diseases.Anemia of inflammation or chronic disease.American Society of Hematology.Anemia.MedlinePlus.Iron deficiency anemia.The Aplastic Anemia and MDS International Foundation.Aplastic anemia causes.John Hopkins Medicine.Hemolytic anemia.Goldstein JL, Cryer B.Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategies.Drug, Healthc Patient Saf.2015;7:31-41. doi:10.2147/DHPS.S71976Madu AJ, Ughasoro MD.Anaemia of chronic disease: an In-depth review.Med Princ Pract. 2017;26(1):1-9. doi:10.1159/000452104Cancer Therapy Advisor.Anemia of chronic disease (anemia of chronic inflammatory disease, hypoferremia of inflammation).Kell DB, Pretorius E.Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells.Metallomics. 2014;6(4):748–773. doi:10.1039/c3mt00347gYokus O, Yilmaz B, Albayrak M, Balcik OS, Helvaci MR, Sennaroglu E.The significance of serum transferrin receptor levels in the diagnosis of the coexistence of anemia of chronic disease and iron deficiency anemia.Eurasian J Med; 43(1):9-12.Merck Manual Professional Version.Anemia of chronic disease.
National Institute of Diabetes and Digestive and Kidney Diseases.Anemia of inflammation or chronic disease.
American Society of Hematology.Anemia.
MedlinePlus.Iron deficiency anemia.
The Aplastic Anemia and MDS International Foundation.Aplastic anemia causes.
John Hopkins Medicine.Hemolytic anemia.
Goldstein JL, Cryer B.Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategies.Drug, Healthc Patient Saf.2015;7:31-41. doi:10.2147/DHPS.S71976
Madu AJ, Ughasoro MD.Anaemia of chronic disease: an In-depth review.Med Princ Pract. 2017;26(1):1-9. doi:10.1159/000452104
Cancer Therapy Advisor.Anemia of chronic disease (anemia of chronic inflammatory disease, hypoferremia of inflammation).
Kell DB, Pretorius E.Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells.Metallomics. 2014;6(4):748–773. doi:10.1039/c3mt00347g
Yokus O, Yilmaz B, Albayrak M, Balcik OS, Helvaci MR, Sennaroglu E.The significance of serum transferrin receptor levels in the diagnosis of the coexistence of anemia of chronic disease and iron deficiency anemia.Eurasian J Med; 43(1):9-12.
Merck Manual Professional Version.Anemia of chronic disease.
Iron Disorders Institute.Anemia of chronic disease.
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