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Anemia of Chronic Diseases: Wider Diagnostics—Better Treatment?

1
Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland
2
Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(6), 1784; https://doi.org/10.3390/nu12061784
Received: 24 April 2020 / Revised: 29 May 2020 / Accepted: 10 June 2020 / Published: 16 June 2020
(This article belongs to the Special Issue Dietary Iron for Human Health)
Anemia of chronic diseases is a condition that accompanies a specific underlying disease, in which there is a decrease in hemoglobin, hematocrit and erythrocyte counts due to a complex process, usually initiated by cellular immunity mechanisms and pro-inflammatory cytokines and hepcidin. This is the second most common type of anemia after iron deficiency anemia in the world. Its severity generally correlates with the severity of the underlying disease. This disease most often coexists with chronic inflammation, autoimmune diseases, cancer, and kidney failure. Before starting treatment, one should undertake in-depth diagnostics, which includes not only assessment of complete blood count and biochemical parameters, but also severity of the underlying disease. The differential diagnosis of anemia of chronic diseases is primarily based on the exclusion of other types of anemia, in particular iron deficiency. The main features of anemia of chronic diseases include mild to moderate lowering of hemoglobin level, decreased percentage of reticulocyte count, low iron and transferrin concentration, but increased ferritin. Due to the increasingly better knowledge of the pathomechanism of chronic diseases and cancer biology, the diagnosis of this anemia is constantly expanding with new biochemical indicators. These include: the concentration of other hematopoietic factors (folic acid, vitamin B12), hepcidin, creatinine and erythropoietin. The basic form of treatment of anemia of chronic diseases remains supplementation with iron, folic acid and vitamin B12 as well as a diet rich in the above-mentioned hematopoietic factors. The route of administration (oral, intramuscular or intravenous) requires careful consideration of the benefits and possible side effects, and assessment of the patient’s clinical status. New methods of treating both the underlying disease and anemia are raising hopes. The novel methods are associated not only with supplementing deficiencies, but also with the administration of drugs molecularly targeted to specific proteins or receptors involved in the development of anemia of chronic diseases. View Full-Text
Keywords: iron homeostasis; anemia; iron supplementation; oxidative stress; nutrition; hematological parameters; biochemical parameters; erythropoiesis iron homeostasis; anemia; iron supplementation; oxidative stress; nutrition; hematological parameters; biochemical parameters; erythropoiesis
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MDPI and ACS Style

Wiciński, M.; Liczner, G.; Cadelski, K.; Kołnierzak, T.; Nowaczewska, M.; Malinowski, B. Anemia of Chronic Diseases: Wider Diagnostics—Better Treatment? Nutrients 2020, 12, 1784. https://doi.org/10.3390/nu12061784

AMA Style

Wiciński M, Liczner G, Cadelski K, Kołnierzak T, Nowaczewska M, Malinowski B. Anemia of Chronic Diseases: Wider Diagnostics—Better Treatment? Nutrients. 2020; 12(6):1784. https://doi.org/10.3390/nu12061784

Chicago/Turabian Style

Wiciński, Michał, Grzegorz Liczner, Karol Cadelski, Tadeusz Kołnierzak, Magdalena Nowaczewska, and Bartosz Malinowski. 2020. "Anemia of Chronic Diseases: Wider Diagnostics—Better Treatment?" Nutrients 12, no. 6: 1784. https://doi.org/10.3390/nu12061784

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