Anemia of chronic disease
https://doi.org/10.51793/OS.2021.24.3.010
Abstract
Anemic syndrome is very widespread among the population. Among the pathogenetic variants, anemia of chronic diseases ranks second among various pathogenetic processes, such as prolonged inflammatory processes. This type of anemia occurs in 27% of cases among other anemias, but it should be noted that the incidence of this anemia in some chronic diseases can reach 100%. The article provides basic information about the leading links in the pathogenesis and treatment of anemia of chronic diseases. The pathogenesis is based on a violation of iron metabolism: the exchange of hepcidin, ferroportin, factors that stimulate the production of hepcidin, inflammatory cytokines. To diagnose this type of anemia, it is necessary to carefully collect anamnesis and search for a long-term chronic illness, assess the state of iron metabolism and the level of transferrin, and it is also necessary to differentiate this type of anemia from iron deficiency. The difference between anemia of chronic disease and iron deficiency is that the latter is characterized by an absolute lack of iron, and it is inaccessible to young erythroid precursors. A significant factor is the determination of the type of iron deficiency after the diagnosis of anemia of chronic disease. The basis of the therapeutic approach to the treatment of anemia of chronic disease is the treatment of the underlying disease. In the case when this is not possible, it is necessary to compensate for the anemia by other methods. Modern medicine offers 4 rational approaches to the treatment of anemia of chronic disease: replacement therapy with blood components; ferrotherapy; the use of erythropoiesis stimulants; targeted cytokine therapy.
About the Authors
V. Yu. Pavlova
Kemerovo State Medical University of Ministry of Health of Russia
Russian Federation
Russian Federation
Kemerovo
M. A. Smolkov
Kemerovo State Medical University of Ministry of Health of Russia
Russian Federation
Russian Federation
Kemerovo
References
1. Worldwide prevalence of anemia 1993-2005; WHO Global Database on Anemia Geneva. Bruno de Benoist, Erin McLean, Ines Egli et al., editors. World Health Organization; 2008. Available at: https://apps.who.int/iris/bitstream/handle/10665/43894/9789241596657_eng.pdf?sequence=1/ Accessed: May 6, 2020.
2. Князькова И. И. Анемия хронических заболеваний // Здоров’я України 21 сторіччя. 2016; 5 (378): 48-49. [Knyaz' kova I. I. Anemiya khronicheskikh zabolevaniy [Anemia of chronic diseases] Zdorov’ya Ukraїni 21 storіchchya. 2016; 5 (378): 48–49. (In Russ.)]
3. Poggiali E., Migone De Amicis M., Motta I. Anemia of chronic disease: A unique defect of iron recycling for many different chronic diseases // Eur J Intern Med. 2014; 25 (1): 12-17. PMID: 23988263. DOI: 10.1016/j.ejim.2013.07.011.
4. Weiss G., Goodnough L. T. Anemia of chronic disease / N Engl J Med. 2005; 352 (10): 1011-1023. PMID: 15758012. DOI: 10.1056/NEJMra041809.
5. Means R. T. Jr. The anaemia of infection // Baillieres Best Pract Res Clin Haematol. 2000; 13 (2): 151-162. PMID: 10942618. DOI: 10.1053/beha.1999.0065.
6. Ватутин Н. Т., Смирнова А. С., Калинкина Н. В., Шевелек А. Н. Анемия у больных ревматоидным артритом: особенности патогенеза, диагностики и лечения // РМЖ. 2013; 21 (21): 1069-1072. [Vatutin N. T., Smirnova A. S., Kalinkina N. V., Shevelek A. N. Anemiya u bol'nykh revmatoidnym artritom: osobennosti patogeneza, diagnostiki i lecheniya [Anemia in patients with rheumatoid arthritis: features of pathogenesis, diagnosis and treatment] RMZh. 1913; 21 (21): 1069-1072. (InRuss.)]
7. Шило В. Ю., Добронравов В. А., Земченков А. Ю. и др. Ассоциация нефрологов России; Российское Диализное Общество; Научное общество нефрологов России. Национальные рекомендации «Диагностика и лечение анемии при хронической болезни почек». М., 2014. [Shilo V. Yu., Dobronravov V. A., Zemchenkov A. Yu. еt al. Assotsiatsiya nefrologov Rossii; Rossiyskoe Dializnoe Obshchestvo; Nauchnoe obshchestvo nefrologov Rossii. Natsional'nye rekomendatsii. Diagnostika i lechenie anemii pri khronicheskoy bolezni pochek. [Association of Nephrologists of Russia; Russian Dialysis Society; Scientific Society of Nephrologists of Russia. National guidelines «Diagnosis and treatment of anemia in chronic kidney disease.»] Мoscow, 2014. (InRuss.)]
8. Raj D. S. Role of Interleukin-6 in the Anemia of Chronic Disease // Semin Arthritis Rheum. 2009; 38 (5): 382-388. PMID: 1833687. DOI: 10.1016/j.semarthrit.2008.01.006.
9. Лехмус Т. Ю., Гермаш Е. И., Лехмус В. И., Халитова Г. Г. Патогенез анемии при хронической болезни почек и методы ее коррекции // Медицинский вестник Башкортостана. 2009; 4 (2): 54-55. [Lekhmus T. Y., Germash E. I., Lekhmus V. I., Khalitova G. G. Patogenez anemii pri khronicheskoi bolezni pochek i metody ee korrektsii [Pathogenesis of anemia in chronic disease of the kidneys and methods of its correction] // Bashkortostan Medical Journal. 2009; 4 (2): 54-55. (In Russ.)] DOI: 10.0000/cyberleninka.ru/article/n/patogenez-anemii-pri-hronicheskoy-bolezni-pochek-i-metody-eekorrektsii.
10. Gaspar B. L., Sharma P. Das R: Anemia in malignancies: pathogenetic and diagnostic considerations // Hematology. 2015; 20 (1): 18-25. DOI: 10.1179/1607845414Y.0000000161.
11. Jiang F., Yu W. J., Wang X. H. et al. Regulation of hepcidin through GDF-15 in cancer-related anemia // Clin Chim Acta. 2014; 428: 14-19. PMID: 24384540. DOI: 10.1016/j.cca.2013.10.015.
12. Madu A. J., Ughasoro M. D. Anaemia of Chronic Disease: An In-Depth Review // Med Princ Pract. 2017; 26 (1): 1-9. DOI: 10.1159/000452104.
13. Сахин В. Т., Маджанова Е. Р., Крюков Е. В. и др. Анемия хронических заболеваний: особенности патогенеза и возможности терапевтической коррекции (обзор литературы и результаты собственных исследований) // Онкогематология. 2018; 13 (1): 45-53. [SakhinV. Т., Madzhanova Е. R., Kryukov E. V. еt al. Anemiya khronicheskikh zabolevanii: osobennosti patogeneza i vozmozhnosti terapevticheskoi korrektsii (obzor literatury i rezultaty sobstvennykh issledovanii) [Anemia of chronic disease: features of pathogenesis and possible therapeutic correction (literature review and results of own research)] // Oncohematology. 2018; 13 (1): 45-53. (In Russ.)] DOI: 10.17650/1818-8346-2018-13-1-45-53.
14. Kennedy R., Ovsyannikova I., Haralambieva I. et al. Genome-wide SNP associations with rubella-specific cytokine responses in measles-mumpsrubella vaccine recipients // Immunogenetics. 2014; 66 (7-8): 493-499. PMID: 24811271. DOI: 10.1007/s00251-014-0776-3.
Review
For citations:
Pavlova V.Yu., Smolkov M.A. Anemia of chronic disease. Lechaschi Vrach. 2021;(3):51-55. (In Russ.) https://doi.org/10.51793/OS.2021.24.3.010
Views:
634
JATS XML
Email this article 
