Anemia of Chronic disease: Diagnosis, Treatment

How is diagnosis of Anemia of Chronic Disease
Diagnosis of Anemia of Chronic Disease include inquire about your symptoms and medical history, particularly any history of chronic inflammatory or infectious disease or cancer, and perform a physical exam. CBC test may include:

• Red blood cell count
• Hemoglobin level
• Serum iron level
• Serum ferritin level
• Serum transferrin receptor level
• Transferrin iron binding capacity
• Total iron binding capacity (TIBC)

If anemia of chronic disease is suspected, serum iron, transferrin, transferrin receptor, and serum ferritin are obtained. Hb usually is > 8 g/dL unless an additional mechanism contributes to anemia. If iron deficiency is present in addition to anemia of chronic disease, serum ferritin generally remains < 100 ng/mL, and, if there is infection, inflammation, or cancer, a ferritin level of slightly < 100 ng/mL suggests that iron deficiency is superimposed on anemia of chronic disease. However, because serum ferritin may be falsely elevated as an acute-phase reactant, the serum transferrin receptor may better differentiate iron deficiency from anemia of chronic disease when serum ferritin is > 100 ng/mL.

A bone marrow biopsy may be performed. When examining the bone marrow, the most important factor is to measure iron levels. With anemia of chronic disease, iron stores will be increased in the bone marrow. This helps in making the diagnosis because an increase in iron stores, combined with low serum iron levels, is found in anemia of chronic disease.

How is treatment of Anemia of Chronic Disease
Treatment of Anemia of Chronic Disease is important to find and treat the underlying cause of the anemia. Once all other causes of anemia are ruled out and the inflammation, infection, or other problem is identified and treated, the anemia can be improved. A blood transfusion may be helpful if the anemia is severe, and hormone replacement therapy may be used if the anemia is caused by endocrine failure. When the anemia is caused by liver disease, treatment to restore liver function usually improves it.

During the treatment of anemia of chronic disease, it's important to consider the possibility of other contributing factors such as chronic blood loss or non-absorption of iron, which may cause more severe anemia. People with cancer are often malnourished and may have an iron deficiency.

Additionally, drugs that help stimulate growth of new red blood cells, like erythropoietin, may be given temporarily. These drugs do have risks that are important to consider before treatment.