Anaemia

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Anaemia Caused by Chronic Diseases

Chronic (long term) illnesses can cause anaemia. Often, anaemia caused by chronic diseases goes undetected until a routine test such as a full blood count reveals abnormal results. Several follow-up tests may be used to discover the underlying cause. The anaemia in these cases is generally caused inflammation causing too much or too little production of various substances and resultant suppression of the normal function of the bone marrow. There are many chronic conditions and diseases that can result in anaemia. Some examples of these include:

  • Kidney disease—Red blood cells are produced by the bone marrow in response to a hormone called erythropoietin, made primarily by the kidneys. Chronic kidney disease can cause anaemia resulting from too little production of this hormone; the anaemia can be treated by giving erythropoietin injections.
  • Inflammatory conditions—Whenever there are chronic diseases that stimulate the body’s inflammatory system, the ability of the bone marrow to respond to erythropoietin is reduced. For example, rheumatoid arthritis (a severe form of joint disease caused by the body attacking its own joints, termed an autoimmune disease) can cause anaemia by reducing the effectiveness of erythropoietin on bone marrow.
  • Other diseases that can produce anaemia in the same way as inflammatory conditions include chronic infections (such as with HIV or tuberculosis), cancer, and cirrhosis.

A number of additional tests may be requested after initial tests (FBC and blood film) have been found to be abnormal. These will help discover the underlying cause of chronic anaemia. Some of these may include:

Treatment of anaemia due to chronic conditions usually involves determining and/or resolving the underlying disease. Blood transfusions may be used to treat the condition in the short term. Erythropoietic stimulating agents such as synthetic versions of Erythropoietin are widely used in patients with chronic kidney diseases.

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