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Last Updated on November 14, 2025 by Ugurkan Demir
Anemia of Chronic Disease (ACD) is linked to long-term inflammatory, infectious, or malignant issues. It happens when chronic inflammation stops the body from using iron to make enough red blood cells.
Many conditions can cause chronic inflammation, like autoimmune diseases, cancer, and chronic infections. The National Institute of Diabetes and Digestive and Kidney Diseases says it can lead to anemia. This is because it affects how the body uses iron and makes red blood cells.
Anemia of Chronic Disease (ACD) is a condition that affects millions worldwide. It happens when chronic diseases make it hard for the body to use iron. This leads to fewer red blood cells and shorter red blood cell life.
ACD is linked to chronic diseases like infections and cancers. It’s caused by impaired iron utilization, reduced erythropoiesis, and shortened red blood cell survival. These issues come from the body’s response to chronic illness, involving the immune system and inflammation.
The main signs of ACD are:
ACD is different from iron deficiency anemia. While iron deficiency anemia lacks iron, ACD has enough iron but can’t use it well. This makes ACD harder to treat, as it often needs to address the chronic condition, not just iron levels.
The main differences between ACD and other anemias are summarized below:
| Characteristics | Anemia of Chronic Disease (ACD) | Iron Deficiency Anemia |
| Iron Stores | Normal or Increased | Decreased |
| Iron Utilization | Impaired | Normal, but insufficient due to lack of iron |
| Erythropoiesis | Reduced | Reduced due to a lack of iron |
Autoimmune diseases lead to chronic inflammation, which causes Anemia of Chronic Disease (ACD). These diseases happen when the body attacks its own tissues. This leads to inflammation and problems like ACD. We’ll look at how certain diseases cause ACD.
Rheumatoid Arthritis (RA) mainly affects joints but can harm other parts of the body too. The ongoing inflammation in RA can cause ACD. Studies show RA patients are more likely to get ACD because of the constant inflammation.
The inflammation in RA makes cytokines, proteins that increase inflammation. These cytokines can lower erythropoietin levels. Erythropoietin is key for making red blood cells, leading to anemia.
Systemic Lupus Erythematosus (SLE) is another disease that can lead to ACD. SLE causes symptoms like joint pain, skin rashes, and kidney damage. The chronic inflammation and immune system issues in SLE can cause ACD.
SLE patients often have anemia due to inflammation and treatment side effects. Treating SLE and anemia requires a detailed plan. This includes medicines to control inflammation and balance the immune system.
Inflammatory Bowel Disease (IBD) includes Crohn’s disease and ulcerative colitis. It causes long-term inflammation in the gut. This inflammation can lead to ACD.
The inflammation in IBD can make it hard to absorb nutrients like iron, vitamin B12, and folate. These nutrients are important for making red blood cells. The inflammation can also affect erythropoietin production and red blood cell lifespan, causing ACD.
| Autoimmune Disease | Primary Effects | Link to ACD |
| Rheumatoid Arthritis (RA) | Chronic joint inflammation | Cytokine-mediated inflammation affecting erythropoietin production |
| Systemic Lupus Erythematosus (SLE) | Multi-organ inflammation and damage | Chronic inflammation and immune dysregulation |
| Inflammatory Bowel Disease (IBD) | Gastrointestinal tract inflammation | Malabsorption of nutrients and chronic inflammation |
It’s important to understand how these diseases lead to ACD. This knowledge helps healthcare providers give better care. They can watch for anemia and treat it properly.
Chronic infections, like bacterial and viral ones, raise the risk of Anemia of Chronic Disease (ACD). Long-term infections often cause chronic inflammation. This inflammation can harm the body’s ability to make red blood cells.
Long-term infections can trigger the body’s inflammatory response. This response fights off the infection but can also reduce iron for red blood cells. This is how infections can lead to ACD.
Tuberculosis (TB) is a chronic bacterial infection that can cause ACD. TB affects millions and can lead to serious health issues, including anemia. Other bacterial infections, like osteomyelitis and bacterial endocarditis, can also cause ACD due to chronic inflammation.
These infections produce cytokines, which promote inflammation. Cytokines can block the production of erythropoietin, a hormone needed for red blood cells. They can also affect iron metabolism, leading to anemia.
Viral infections, like HIV/AIDS, are a big cause of ACD. HIV infection activates the immune system constantly, leading to inflammation. This inflammation can slow down red blood cell production. Other viral infections, such as hepatitis B and C, can also cause ACD.
The chronic inflammation from these viral infections can lower red blood cell production. It can also increase the destruction of these cells, causing anemia. It’s important to manage these infections to help red blood cell production.
Other chronic conditions, like diabetes, cancer, and severe chronic kidney disease, can also lead to ACD. This shows how different chronic diseases can affect red blood cell production.
Cancer can make it hard for the body to make red blood cells, causing Anemia of Chronic Disease (ACD). This is because cancer can cause long-term inflammation and mess with how red blood cells are made.
We will look at how different cancers affect red blood cell production.
Solid tumors, like those in breast, lung, and colon cancer, can cause ACD. This happens because of chronic inflammation and cytokines that slow down the production of red blood cells.
A study found that cancer’s chronic inflammation can lower hemoglobin levels, leading to anemia.
“Chronic inflammation in cancer patients can lead to a decrease in hemoglobin levels, contributing to anemia.”
| Type of Cancer | Mechanism Leading to ACD | Impact on Red Blood Cell Production |
| Solid Tumors (e.g., Breast, Lung, Colon) | Chronic Inflammation, Cytokine Release | Suppression of Erythropoiesis |
| Hematologic Malignancies (e.g., Lymphoma, Leukemia) | Infiltration of Bone Marrow, Disruption of Erythropoiesis | Reduced Production of Red Blood Cells |
Hematologic malignancies, like lymphoma and leukemia, can harm the bone marrow. This is where red blood cells are made. This harm can lead to fewer red blood cells and anemia.
The effect of hematologic malignancies on red blood cell production can be big. It can cause severe anemia that needs medical help.
It’s key to understand how cancer and ACD are linked. This helps doctors give the right care to cancer patients. Knowing how cancer causes anemia helps doctors find good treatments.
To diagnose Anemia of Chronic Disease (ACD), we use a detailed approach. This includes clinical assessment, lab tests, and understanding the chronic disease. We’ll explain how to diagnose ACD and why it’s key to manage it well.
Diagnosing ACD starts with a detailed look at the patient’s history and physical exam. We check the patient’s medical history for chronic diseases that might cause anemia. We also do a physical exam to find signs of anemia or a chronic disease.
Key parts of the clinical assessment are:
Lab tests are vital for diagnosing ACD. We check the patient’s red blood cells, iron levels, and inflammation. The main tests are:
It’s hard to tell ACD from iron deficiency anemia (IDA) because both can have low serum iron. But, serum ferritin levels are key. In ACD, ferritin is normal or high, showing enough iron. In IDA, ferritin is low, meaning iron is low.
To tell ACD from IDA, we look at:
By combining clinical checks with lab tests, we can accurately diagnose ACD. This helps us treat it properly and avoid mistaking it for other anemias.
Understanding Anemia of Chronic Disease (ACD) is key to managing it well. ACD is anemia linked to long-term diseases like autoimmune disorders and cancers. It’s important to know about it.
Treating the main disease is the first step in managing ACD. Sometimes, extra treatments like erythropoietin or blood transfusions are needed. These help with anemia symptoms.
Diagnosing ACD means a detailed check-up and lab tests. It’s important to tell it apart from other anemias, like iron deficiency anemia. Getting the right diagnosis is critical for the right treatment.
Healthcare teams can create good treatment plans by knowing ACD’s causes and diagnosis. We focus on treating the main disease to manage ACD. This improves patients’ lives and health.
Managing ACD well needs a team effort. It involves the latest research and treatments. As we learn more about ACD, we can help patients more effectively.
Anemia of Chronic Disease (ACD) is a condition where anemia happens with chronic diseases. This includes inflammatory, infectious, or malignant diseases. It’s because the body can’t make enough red blood cells due to chronic inflammation.
Main causes of ACD include chronic inflammatory diseases like rheumatoid arthritis. It also includes systemic lupus erythematosus and inflammatory bowel disease. Chronic infections like tuberculosis and HIV, and malignancies like solid tumors and hematologic malignancies are also causes.
Chronic inflammation makes it hard for the body to use iron. It also reduces the production of red blood cells and shortens their survival. This leads to anemia.
Autoimmune diseases linked to ACD include rheumatoid arthritis and systemic lupus erythematosus. Inflammatory bowel disease is also associated. These diseases cause chronic inflammation, leading to ACD.
Yes, chronic infections like tuberculosis and viral infections like HIV can cause ACD. They lead to chronic inflammation.
Malignancies, including solid tumors and hematologic malignancies, can affect red blood cell production. They lead to ACD due to chronic inflammation and other changes.
Diagnosing ACD involves clinical assessment and laboratory testing. It’s important to differentiate it from iron deficiency anemia. Accurate diagnosis is key to effective management.
Tests for diagnosing ACD include complete blood count (CBC) and iron studies. Markers of inflammation like C-reactive protein (CRP) are also used. These tests help distinguish ACD from other anemias.
Yes, ACD is a chronic condition due to its association with chronic diseases. Managing the underlying condition is essential for managing ACD.
Treatment for ACD includes addressing the underlying chronic disease. Iron supplementation and erythropoiesis-stimulating agents may also be used. The goal is to manage the anemia and improve the quality of life.
