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Anemia of chronic disease


Anemia 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.

I Would Like to Learn About:

  • Causes

    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, hepatitis B or hepatitis C
  • Symptoms

    Anemia of chronic disease is often mild. You may not notice any symptoms.

    When symptoms occur, they may include:

    • Feeling weak or tired
    • Headache
    • Paleness
    • Shortness of breath
  • Exams and Tests

    The doctor 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:

    • Hemoglobin level
    • Red blood count
    • Reticulocyte count
    • Serum ferritin level
    • Serum iron level
    • Other blood tests
  • Treatment

    Anemia is often mild enough that it does not need treatment. It will likely get better when the disease that is causing it is treated.

    The condition is rarely severe enough to need a blood transfusion.

  • Outlook (Prognosis)

    The anemia will improve when the disease that is causing it is treated.

  • Possible Complications

    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 health care provider if you have a long-term (chronic) disorder and you develop symptoms of anemia.


Related Information

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Ferri FF. Inflammatory anemia. In: Ferri FF, ed. Ferri's Clinical Advisor 2016. Philadelphia, PA: Elsevier; 2016:703-704.

Little JA, Benz EJ Jr, Gardner LB. Anemia of chronic diseases. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 35.



Review Date: 2/1/2016  

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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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