Summary Pharmacy;anaemia of chronic disease

Anaemia of chronic disease

• Mild microcytic or normocytic anaemia can be caused by ACD
• Causes of ACD:
➢ Malignancy
➢ Rheumatological diseases - rheumatoid arthritis, polymyalgia
➢ Chronic infection
• Inflammatory cytokines cause reduced iron utilisation and impaired RBC
production
• Severity of anaemia reflects disease activity
• Anaemia only improves if the underlying disease is successfully treated or
controlled




Renal anaemia

•CKD could be a possible cause of anaemia if GFR <60
•CKD is a likely cause if GFR <30 (or <45 in diabetics)
•Should not be assessed until iron deficiency is corrected
•Can measure serum erythropoietin in clinic (remember EPO is produced by
the kidneys)
Haemolytic anaemia

• This is the abnormal breakdown of red blood cells (RBCs), either in the blood
vessels (intravascular hemolysis) or elsewhere in the human body
(extravascular, but usually in the spleen)
• Normal RBCs survive for around 120 days in circulation
• The bone marrow can compensate for mild reductions but in severe cases the
survival may be down to just a few days and patients will be pale and
jaundiced
• Mild haemolysis is seen in thalassaemia and sickle cell disease
Thalassaemia