Anemia of Chronic Disease
In anemia of chronic disease, some chronic disorder slows the production of red blood cells, the result of production of proteins called cytokines that interfere with the production of red blood cells.
Chronic disease often leads to anemia, especially in older adults. Conditions such as infections, inflammation, and cancer particularly suppress production of red blood cells in the bone marrow. Since the suppression is usually not severe, anemia develops slowly and is evident only after time. Because the bone marrow is unable to use stored iron in the developing red blood cells, this type of anemia is often called iron-reutilization anemia.
Because this type of anemia develops slowly and is generally mild, it usually produces few or no symptoms. When symptoms do occur, they usually result from the disease causing the anemia rather than from the anemia itself. There are no specific laboratory tests, so the diagnosis is typically made by excluding other causes.
Because no specific treatment exists for this type of anemia, doctors treat the disease causing it. Taking additional iron or vitamins does not help. On the rare occasion that the anemia becomes severe, transfusions may help. Alternatively, erythropoietin or darbepoietin, drugs that stimulate the bone marrow to produce red blood cells, may be given.
 See the sidebar Aplastic Anemia: When the Bone Marrow Shuts Down.
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