What happens when chronic anemia of disease is not treated?

Chronic anemia of disease happens when you have an autoimmune disease or other illness lasts longer than three months and that causes inflammation. Chronic inflammation can affect your body’s ability to use iron needed to make enough red blood cells. Anemia happens when you don’t have enough red blood cells.

What is chronic anemia of disease?

Chronic anemia of disease happens when you have an autoimmune disease or other illness lasts longer than three months and that causes inflammation. (Providers may use the term anemia of inflammation or anemia of inflammation and chronic disease). Chronic inflammation can affect your body’s ability to use iron needed to make enough red blood cells. Anemia happens when you don’t have enough red blood cells. Most of the people who have anemia of chronic disease have a mild form of the condition. Healthcare providers treat chronic anemia of disease by treating the underlying condition.

Who is affected by chronic anemia of disease?

Like its name, chronic anemia of disease may affect anyone who has a chronic illness. Anyone who has a chronic illness may develop chronic anemia of disease. That said, most of the people who have this condition are age 65 and older. Studies indicate about 1 million people in the United States age 65 and older have chronic anemia of disease. Diseases that may cause chronic anemia of disease include:

• Cancer.
• Chronic kidney disease.
• Heart failure (congestive heart failure).
• Autoimmune diseases. These are diseases that attack your immune system instead of protecting it.

What autoimmune diseases cause chronic anemia of disease?

The following autoimmune diseases may cause chronic anemia of disease:

• Rheumatoid arthritis: chronic inflammation of joints.
• Systemic lupus erythematosus (or lupus): tissue damage from an immune system attack on your body.
• Vasculitis: an inflammation of blood vessels.
• Sarcoidosis: an inflammatory disease that commonly affects the lung and lymph glands, most likely caused by an abnormal immune response.
• Inflammatory bowel disease (Crohn’s disease and ulcerative colitis), which affects the intestines.
• Irritable bowel syndrome (IBS).
• Any type of infection.

What conditions may cause chronic anemia of disease?

Chronic anemia of disease is linked to:

• Any type of infection.
• Having obesity.

How common is chronic anemia of disease condition?

It's the second most common type of anemia, after iron-deficiency anemia.

What happens when chronic anemia of disease is not treated?

Different types of chronic anemia of disease have different effects on the body and show different symptoms. The main effects on the body can be seen in the following areas.

1. Nervous system: Dizziness, tinnitus, headache, insomnia, excessive dreaming, memory loss, concentration problems, etc. are common symptoms caused by chronic anemia of disease and lack of oxygen resulting in nerve tissue damage.

2. Skin and mucous membrane: Pallor is the main manifestation of skin and mucous membrane in anemia. The body redistributes the effective blood volume through neurohumoral regulation during chronic anemia of disease, and the blood supply to the secondary organs such as skin and mucous membranes is reduced; in addition, due to the reduction of red blood cells and hemoglobin content per unit volume of blood, it also causes the color of skin and mucous membranes to become pale. Roughness, lack of luster and even ulcers are another type of skin and mucous membrane manifestations in anemia, which may also be related to the primary cause of chronic anemia of disease. Hemolytic anemia, especially extravascular hemolytic anemia, can cause yellow coloring of the skin and mucous membranes.

3. Respiratory and circulatory system: More 2,3-diphosphoglyceric acid (2,3-DPG) is synthesized in red blood cells during anemia to reduce the affinity of hemoglobin for oxygen, so that the oxygen dissociation curve shifts to the right and more oxygen is available to tissues. Shortness of breath or dyspnea is mostly due to hypoxia or hypercapnia in the respiratory center. Therefore, mild anemia has no obvious manifestations, but only activity causes accelerated breathing and deepening with palpitations and accelerated heart rate. The heavier the chronic anemia of disease, the greater the activity, the more obvious the symptoms. In severe anemia, there may be shortness of breath or even seated breathing even in a calm state. Long-term chronic anemia of disease, with overloaded heart and insufficient oxygen supply, can lead to chronic anemia of heart disease, when there are not only heart rate changes, but also arrhythmia and cardiac insufficiency.

4. Digestive system: In chronic anemia of disease, the secretion of digestive glands is reduced or even the glands are atrophied, which leads to reduced digestive function, indigestion, abdominal distension, reduced appetite, and changes in the regularity and character of stools. Long-term chronic hemolysis may be combined with bile duct stones and splenomegaly. Iron-deficiency anemia may be associated with foreign body sensation or heterophilia in swallowing. Megaloblastic anemia or pernicious chronic anemia of disease can cause tongue inflammation, tongue atrophy, beef tongue, mirror tongue, etc.

5. Genitourinary endocrine system: extravascular hemolysis may lead to hyperuriculogenic bilirubinuria without bilirubin; intravascular hemolysis may lead to hemoglobin uria and ferric hemoglobinuria, and in severe cases, free hemoglobin may even block the renal tubules, which may lead to oliguria, anuria and acute renal failure. Long-term chronic anemia of disease affects the secretion of testosterone and diminishes male characteristics; in women, it affects the secretion of female hormones and leads to abnormal menstruation, such as amenorrhea or excessive menstruation. Decreased libido is common in both sexes. Chronic anemia of disease affects the function of endocrine glands and the secretion of erythropoietin.