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Anemia of chronic disease


Authors: L. Raida
Authors‘ workplace: Hemato-onkologická klinika Lékařské fakulty UP a FN, Olomouc, přednosta prof. MUDr. Karel Ondrák, DrSc.
Published in: Vnitř Lék 2005; 91(7 a 8): 878-880
Category: 128th Internal Medicine Day - 21rd Vanysek's Day Brno 2005

Overview

Anemia of chronic disease may be defined as a hypoproliferative one mediated by the increase of cytokines production because of underlying, usually inflammatory or malignant, disorder. The high levels of some cytokines are particularly produced in such diseases and can negatively influence the proliferation and maturation of erythroid progenitors by the decrease of erythropoietin production, iron mobilisation from the cells of reticuloendothelial system and its final incorporation into the erythroblasts. Red cells surviving is shortened and insufficiently compensated by the hypoprolipherative erythropoiesis, as well. In clinical practice, anemia of chronic disease is usually confused with sideropenic one or another, primarily hematological, disease as myelodysplastic syndrome, the type of refractory anemia or refractory anemia with ring sideroblasts. A causal treatment of this anemia is the successful therapy of primary disorder and the elimination of another factors possibly participating on the anemia. The administration of recombinant erythropoietin can be effective and it has become a part of comprehensive supportive care particularly in the patients developed the anemia of chronic disease because of active malignancy.

Key words:
anemia of chronic disease - cytokines - iron - ferritin - transferrin - soluble transferrin receptor - erythropoietin


Sources

1. Brenner MK. Annotation: tumor necrosis factor. Br J Haematol 1988; 69: 149-152.

2. Tracey KJ, Vlassara H, Cerami A. Cachectin/tumor necrosis factor. Lancet 1988; 1: 1122-1125.

3. Durum SK, Schmidt JA, Oppenheim JJ. Interleukin 1: an immunological perspective. Ann Rev Immunol 1985; 3: 263-287.

4. Dinarello CA. Interleukin 1 and its biologically related cytokines. Adv Immunol 1989; 44: 153.

5. Hooks JJ, Moutsopopoulos HM, Geis SA et al. Immune interferon in the circulation of patients with autoimmune disease. N Engl J Med 1979; 301: 5-8.

6. Baer AN, Dessypris EN, Goldwasser E et al. Blunted erythropoietin response to anaemia in rheumatoid arthritis. Br J Haematol 1987; 66: 559-564.

7. Miller CB, Jones RJ, Piantadosi S et al. Decreased erythropoietin response in patients with the anemia of cancer. N Engl J Med 1990; 322: 1689-1692.

8. Faquin WC, Schneider TJ, Goldberg MA. Effect of inflammatory cytokines on hypoxia-induced erythropoietin production. Blood 1992; 79: 1987.

9. Konijn AM, Hershko C. Ferritin synthesis in inflammation. I. Pathogenesis of impaired iron release. Br J Haematol 1977; 37: 7.

10. Ludwiczek S, Aigner E, Theurl I et al. Cytokine-mediated regulation of iron transport in human monocytic cells. Blood 2003; 101: 4148-4154.

11. Douglas SW, Adamson JW. The anemia of chronic disorders: Studies of marrow regulation and iron metabolism. Blood 1975; 45: 55.

12. Rogers J, Durmowicz G, Kasschau K et al. A motif within the 5´non-coding regions of acute phase mRNA mediates control of ferritin translation by IL-1β and may contribute to the anemia of chronic disease (abstract). Blood 1991; 78(Suppl 1): 361a.

13. Moldawer LL, Marano MA, Wei H et al. Cachectin/tumor necrosis factor alters red blood cell kinetics and induces anemia in vivo. FASEB J 1989; 3: 1637-1643.

14. Cartwright GE. The anemia of chronic disorders. Semin Hematol 1966; 3: 351.

15. Genc S, Erten N, Karan MA et al. Soluble transferrin receptor and soluble transferrin receptor-ferritin index for evaluation of the iron status in elderly patients. Tohoku Journal of Experimental Medicine 2004; 202: 135-142.

16. Massey AC. Microcytic anemia. Differential diagnosis and management of iron deficiency anemia. Med Clin North Am 1992; 76: 549.

17. Konijn AM, Carmel N, Levy R et al. Ferritin synthesis in inflammation. II. Mechanism of increased ferritin synthesis. Br J Haematol 1981; 49: 361.

18. Baer AN, Dessypris EN, Krantz SB. The pathogenesis of anemia in rheumatoid arthritis. A clinical and laboratory analysis. Semin Arthritis Rheum 1990; 14: 209-223.

19. Pincus T, Olsen NJ, Russell IJ et al. Multicenter study of recombinant human erythropoetin in correction of anemia in rheumatoid arthritis. Am J Med 1990; 89: 161-168.

20. Nissenson AR et al. Recombinant human erythropoetin and renal anemia: Molecular biology, clinical efficacy, and nervous system effects. Ann Intern Med 1991; 114: 402.

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