Anemia of Chronic Disease (ACD)

Conditions Basics

What is anemia of chronic disease?

Having anemia means you don't have enough red blood cells. Your body needs these cells to carry oxygen from your lungs to the rest of your body. Sometimes a long-term disease keeps your body from making enough red blood cells. This is called anemia of chronic disease, or ACD.

What causes it?

Anemia of chronic disease is caused by changes in the body that are triggered by a chronic disease. These changes can include:

• A problem with using iron to make red blood cells, even when there's enough iron in the body.
• Bone marrow that can't make red blood cells as well as it should.
• Red blood cells that don't live as long as they should.

One of the main causes of anemia of chronic disease is ongoing inflammation from autoimmune diseases such as rheumatoid arthritis, lupus, and inflammatory bowel disease. Other chronic conditions that can lead to anemia include diabetes, cancer, infection, and severe chronic kidney disease.

What are the symptoms?

You may find that anemia of chronic disease causes mild symptoms or no symptoms at all. If you do have symptoms, you may feel dizzy, tired, and weak. You may also feel your heart pounding or feel short of breath. It may be hard to focus and think clearly.

How is it diagnosed?

A blood test, sometimes done as part of a routine exam, tells your doctor if you have anemia. Your doctor may then do other tests to look for a cause.

Your doctor may diagnose you with anemia of chronic disease if:

• You have a chronic disease or health problem that's known to cause anemia.
• Your symptoms and test results don't point to other types of anemia, such as pernicious anemia, hemolytic anemia, or iron deficiency anemia.

How is anemia of chronic disease treated?

Anemia of chronic disease (ACD) is most often treated by treating the health problem that caused it. For example, treating rheumatoid arthritis can lower inflammation, which can then improve ACD.

For ACD caused by cancer or chronic kidney disease, medicine can help the body make more red blood cells. These medicines are called erythropoietin stimulating agents, or ESAs.

Severe anemia is treated with a blood transfusion of red blood cells, no matter what the cause is.

Only take iron if your doctor tells you to. Unless you also have iron deficiency anemia, taking iron does not help with ACD. If your iron level is normal, taking extra iron can be dangerous.