Anemia due to chronic disease is a disorder that occurs due to a decrease in secondary hemoglobin levels in the body due to chronic disease. This problem can be caused by various possible previous chronic diseases. Examples include cancer, infections, autoimmune diseases, and inflammatory diseases, such as rheumatoid arthritis or kidney disease.
This type of anemia is the second most common cause of anemia after iron deficiency anemia. Usually, this disease occurs in the elderly who suffer from chronic diseases, and require special care, either at home or hospitalized. This condition is also called anemia of inflammation and chronic disease.
Symptoms of Anemia Due to Chronic Disease
The complaints experienced by anemia sufferers vary depending on the severity of the anemia. Usually, chronic diseases cause mild or moderate anemia. However, in certain circumstances, severe anemia can also occur. In mild anemia, sufferers may not experience symptoms. In more severe conditions, general symptoms of anemia can occur, such as:
- Pale.
- Weak.
- Dizzy.
- Hard to breathe.
- Rapid heartbeat.
- Chest pain.
Risk Factors for Anemia Due to Chronic Disease
Some of the most common risk factors that can cause anemia due to chronic disease include:
- Suffering from infection.
- Having cancer.
- Chronic kidney disease (Almost everyone with this type of disease will have anemia because the kidneys make erythropoietin (EPO), a hormone that controls the production of red blood cells in the bone marrow.)
- Autoimmune disease.
- Suffering from rheumatoid arthritis, chronic inflammation of the joints.
- Systemic lupus erythematosus (or lupus), tissue damage caused by an attack by the immune system.
- Sarcoidosis, an inflammatory disease that usually affects the lungs and lymph nodes, is most likely caused by an abnormal immune response.
- Vasculitis, which is inflammation of the blood vessels.
- Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis.
- Chronic rejection of a transplanted organ.
- Heart failure.
Causes of Anemia due to Chronic Disease
Until now, the specific cause of anemia caused by chronic disease has not been confirmed. However, experts estimate that the cause is an infection or disease that causes inflammation. When inflammation occurs in the body, the immune system will change, resulting in:
- The body cannot store or use iron normally to form new red blood cells
- Kidney hormones to trigger bone marrow to produce red blood cells are reduced
- Bone marrow cannot respond normally to kidney hormones.
- The life span of red blood cells is reduced from its normal time of around 120 days.
Meanwhile, as the name suggests, chronic diseases that can trigger anemia due to chronic diseases include:
- Cancer, cancer cells can release certain substances that damage or destroy immature red blood cells.
- Chronic kidney disease, because the kidneys cannot produce enough erythropoietin which causes a decrease in red blood cells and anemia.
- Heart failure.
- Diabetes.
- HIV/AIDS.
- Tuberculosis.
- Autoimmune diseases such as Crohn’s disease, systemic lupus erythematosus, rheumatoid arthritis, and ulcerative colitis.
Diagnosis of Anemia Due to Chronic Disease
Diagnosis of anemia in chronic disease is based on questions about the patient’s medical history and a physical examination. If there are signs and symptoms that indicate this disease, the doctor will likely perform several additional examinations to confirm the diagnosis, such as:
- Complete blood count
The purpose of this examination is to see the hemoglobin level, the size of the red blood cells, and to see if there are any signs of infection or inflammation.
- Iron test
This examination is to screen for anemia due to iron deficiency, as well as to be a reference for therapy.
- Radiological examination or other supporting examinations
The type of examination depends on the clinical condition, used to look for underlying disease.
Treatment of Anemia Due to Chronic Disease
The main goal of anemia therapy in chronic diseases is to improve the blood’s ability to transport oxygen throughout the body, as well as detect and treat the underlying cause. Various therapy methods that can be given to anemia sufferers due to chronic diseases include:
- Iron supplementation
Iron supplements are usually given if there is an indication of iron deficiency and the doctor will weigh the benefits compared to the possible risks of harm. This is because in some diseases, such as cancer and infections, iron is used to grow and develop.
- Red blood cell transfusion
Blood transfusions are used for severe anemia or severe complaints to immediately restore normal red blood cell levels.
- Therapy with erythropoietin-stimulating agents
This therapy method aims to stimulate the bone marrow in producing new red blood cells. Side effects that can arise with the administration of erythropoietin include increased blood pressure, hypertensive encephalopathy, thromboembolic complications, iron deficiency, and flu-like symptoms.
- Cytokine-targeted therapies, such as anti-hepcidin and omega-3 fatty acids
This type of therapy is still partly in the development and research stage.
Complications of Anemia Due to Chronic Disease
Untreated anemia can be life-threatening and can even cause death. Anemia causes a decrease in the oxygen-carrying capacity of the blood. In the short term, the body will experience an increase in heart rate and breathing rate.
If left untreated, anemia of chronic disease can lead to failure in other organs. This can include heart failure, angina, arrhythmias, cognitive impairment, and kidney failure. In pregnant women, anemia of chronic disease can lead to premature birth and low birth weight.
Prevention of Anemia due to Chronic Disease
So far, experts have not found a way to prevent anemia due to chronic disease. For some chronic conditions that cause inflammation, treatment may be done to reduce or prevent inflammation that can cause anemia.
However, there are various things you can do to prevent anemia due to chronic diseases, including maintaining your health, such as:
- Consume nutritious foods with sufficient iron, folate, and vitamin B12.
- Exercise regularly.
- Minimize crowds with many people to prevent infection.
- If you have a disease, get treatment immediately until you are cured or have regular check-ups for chronic diseases that cannot be cured.
When to See a Doctor?
If you experience complaints that match the symptoms of anemia due to chronic disease, immediately talk to a doctor to confirm the diagnosis and get the right treatment. To prevent anemia due to chronic disease, you are also advised to consume supplements or blood-boosting vitamins.