Definition:
Anemia of chronic disorders develops in chronic inflammatory (especially rheumatic), infectious, and malignant diseases. It is the second most common form of anemia world wide after iron deficiency anemia .
The cause of anemia of chronic disorders is not fully understood. No doubt, it is a combination of the erythrocyte's slightly shorter lifespan (80-90 days instead of 100-120 days), and a restriction of erythropoiesis due to a disturbance of iron utilization as well as inhibiting cytokines (e.g. tumor necrosis factor).
Clinical Picture:
This anemia is rarely severe (Hb in most cases > 90 g/L). Its severity usually correlates with the severity of the underlying disease process. The patients most often have asymptomatic anemia. Frequent symptoms such as fatigue and weakness can also be caused by the underlying illness.
Hematology:
Anemia of chronic disorders is normally normochromic and normocytic with a tendency to be hypochromic-microcytic. Serum iron and iron binding capacity are decreased, while the serum ferritin is normal or high. Please note! Anemia of chronic disorders and iron deficiency anemia often coexist (e.g., in the case of patients with rheumatoid arthritis and drug-induced gastrointestinal bleeding).
Bone marrow:
The examination of bone marrow is not an essential component of the clinical investigation of anemia of chronic disorders. However, it can be helpful to exclude iron deficiency anemia. In anemia of chronic disorders, the iron content of bone marrow is typically normal or increased.