· Causes:
o Chronic infections e.g. TB, SBE, AIDS
o Chronic inflammatory states e.g. RA, ulcerative colitis
o Recognise it so patient is not over-investigated
· Features:
o Mild to moderate anaemia: 70 – 100 g/L (usually 90 – 100)
o Normocytic to mild microcytosis
· Differential diagnosis
o Fe deficiency
o Renal impairment
o Marrow infiltration
o Haemolysis
· Iron Studies (highly examinable):
· Blood results in chronic disease:
o Ferritin
o ¯Protein (especially albumin)
o Globulins
· Pathogenesis
o RBC destruction ® ¯survival
o ¯Iron metabolism
o Impaired erythropoietin response
o Cytokines (TNF-a, IL-1, interferons)
· Treatment
o Won‟t respond to iron, etc
o Treat underlying cause
o Erythropoietin (but very expensive)
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