Note
You are in a sub-theme of the anemia section. You can find general information on this topic under: Anaemia
Introduction
This is the second most common form of anaemia. Due to a chronic disease, anaemia occurs as a consequence or accompanying symptom.
Cause and development of disease (pathophysiology)
As a growth factor, the hormone erythropoietin (also known as EPO), which is mainly produced by lack of oxygen in the kidney, but also partly in the liver, is important. Via the bloodstream it reaches the haematopoietic system in the bone marrow and as a transcription factor stimulates erythropoiesis. It thus has an anti-apoptotic effect, i.e. it prevents the premature breakdown of precursor cells in the bone marrow.
This function is inhibited in chronic inflammation in the body. If the iron content is sufficient, the cells can still mature fully. However, if the inflammation lasts for a long time, iron utilization is also impaired.
The inflammation also influences the formation of EPO. As a result, the red blood cells are too small and can transport less oxygen (microcytic hypochromic anaemia). The causes are on the one hand tumour diseases.
Furthermore, chronic infections such as : can be the cause. However, the most common cause is chronic inflammation such as rheumatoid arthritis (inflammation of the joints, “rheumatism“), intestinal diseases (Crohn’s disease, ulcerative colitis), systemic lupus erythematosusLupus erythematosus, etc. A weakness of the renal capacity (renal insufficiency – renal insufficiency) is the most common reason for an erythropoietin deficiency. – an inflammation of the inner skin of the heart (endocarditis lenta)
- Bone softening (osteomyelitis) or
- Tuberculosis
Diagnostics
The blood count shows increased inflammation values such as the oxygen-transporting protein haemoglobin (Hb) is reduced. The red blood cells can be normal (normochrome-normocytic) or reduced in size (microcytic-hypochrome). The iron content in the blood is reduced, ferritin is increased.
The number of red blood cells is lower. In addition, parameters such as the soluble transferrin receptor and reticulocyte haemoglobin allow the distinction from iron deficiency anaemia. – CRP (C-reactive protein) and
- White blood cells (leukocytes).
Therapy
The therapy consists of eliminating the cause, if possible. A substitution of the hormone erythropoietin (EPO) is possible, but expensive.
