Anaemia caused by long-term illness

Clinically: Anaemia of chronic disease · also anemia of inflammation, ACD, anemia due to chronic disorder

hematologic MONDO MONDO:0020725 unverified

This describes what this condition typically looks like. It is not a diagnosis and cannot tell you whether you have it -- patterns overlap, results vary between labs, and the same numbers mean different things in different people. Diagnosis usually rests on Hemoglobin, interpreted alongside symptoms and history rather than read off a report.

unverified These explanations are written to be easy to read and have not yet been checked against a source. The ranges and measurement notes on this page show theirs.

definition unverified

When the body is inflamed for a long time, it deliberately locks iron away from the bloodstream. Iron stores are adequate but unavailable, so red cell production falls even though there is iron in the tank.

Anaemia arising in chronic inflammatory conditions (autoimmune disease, cancer, chronic infection), in which inflammation-induced hepcidin degrades the iron exporter ferroportin, sequestering iron in reticuloendothelial macrophages; serum iron and transferrin saturation fall although total body iron stores are preserved or increased, and erythropoietin production and signalling are impaired.

caveats unverified

The confusing part is that ferritin looks normal or high here, because inflammation raises it. Telling this apart from plain iron deficiency is a common reason to check an inflammation marker at the same time.

No clinical version written yet.

How common it is

The second most common form of anaemia after iron deficiency.

The typical lab pattern

What the diagnosis rests on

The results a diagnosis is actually made on.

Hemoglobin

low

—

It is an anaemia: haemoglobin below 120 g/L in women or 130 g/L in men, together with inflammation and its typical iron pattern.

Consistent with it

Fits the picture, but not enough on its own.

C-reactive protein	high	—	Signs of inflammation, such as a raised CRP, are expected and support the diagnosis. CRP is one of the tests used to work it up.
Ferritin	high	—	Ferritin is normal or raised (often above 100 µg/L), unlike iron deficiency where it is low (below 30 µg/L). It is the most useful test for telling the two apart.
Iron, serum	low	—	Low serum iron (hypoferraemia) with normal or high ferritin is the typical iron pattern.
Mean corpuscular volume	low	—	Usually normal; sometimes mildly low. A normal MCV helps separate it from iron deficiency, where red cells are small.

How it usually feels

Feeling tired all the time · common
Getting out of breath easily · occasional
Looking unusually pale · occasional

Frequencies say how often a symptom accompanies this condition — not the other way round. Most people with any of these symptoms do not have this.