Re[2]: long standing question

[Guest guest]

Hello JAMY,

Saturday, July 31, 2004, 3:19:31 PM, you wrote:

JR> what type of chronic disease and can you point in to some articles maybe?

Any chronic disease - but especially ones which involve an

inflammatory process such as RA , TB, coeliac, crohns and

Thyroid disease [underactive thyroid or Hashimotos]

Am J Med Sci. 1994 May;307(5):353-9. Related Articles, Links

Pathogenesis and treatment of the anemia of chronic disease.

Krantz SB.

Department of Medicine, Department of Veterans Affairs Medical Center,

Nashville, Tennessee.

The anemia of chronic disease may be viewed simply as the anemia that

accompanies chronic inflammatory, infectious, or neoplastic disorders. Because

these conditions are very common, the anemia of chronic disease is one of the

most frequent anemias encountered, and is only second in incidence to

iron-deficiency anemia. The anemia of chronic disease is primarily an anemia due

to underproduction of red cells, with low reticulocyte production, and is most

often a normochromic, normocytic anemia. However, in 30% to 50% of patients, the

red cells are hypochromic and microcytic and, most often, the serum iron, total

iron-binding capacity, and transferrin saturation are reduced in the presence of

adequate iron stores. Although the differential diagnosis includes other

underproduction anemias, such as those caused by vitamin and mineral

deficiencies, renal failure, endocrinopathies, and myelodysplasia, it generally

is easily distinguished from these conditions. Nevertheless, an understanding of

the pathogenesis of this condition, as well as a means of alleviating the anemia

when the chronic disorder persists, has remained elusive. Recently, major

advances have occurred toward understanding the pathogenesis of the anemia of

chronic disease and its treatment, and these advances are reviewed.

also

Blood Rev. 2002 Jun;16(2):87-96. Related Articles, Links

Click here to read

Pathogenesis and treatment of anaemia of chronic disease.

Weiss G.

Department of Internal Medicine, University Hospital, Anichstr 35, A-6020

Innsbruck, Austria. guenter.weiss@...

Anaemia of chronic disease (ACD), the most frequent anaemia among

hospitalized patients, develops under chronic inflammatory disorders such as

chronic infections, cancer or autoimmune diseases. A number of different

pathways contribute to ACD, such as diversion of iron traffic, a diminished

erythropoiesis, a blunted response to erythropoietin, erythrophagocytosis and

bone marrow invasion by tumour cells and pathogens. Nevertheless, ACD is a

reflection of an activated immune system and possibly results from an innovative

defence strategy of the body in order to withdraw the essential growth factor

iron from invading pathogens and to increase the efficacy of cell-mediated

immunity. Diagnosis of ACD can be assessed by examination of chances in serum

iron parameters with low to normal serum iron, transferrin saturation and

transferrin concentrations on the one hand and normal to increased ferritin,

zinc protoporphyrin IX and cytokine levels on the other side. Therapy of ACD

includes the cure of the underlying the disease. Apart from this transfusions

for rapid correction of haemoglobin levels, and human recombinant erythropoietin

for prolonged therapy are used. However, response rates to recombinant

erythropoietin are sometimes low. Iron alone should be strictly avoided due to

its growth-promoting effect towards micro-organisms and tumour cells and because

of it capacity to inhibit T-cell-mediated immune effector pathways. We urgently

need prospective clinical trials to gain knowledge about the effects of anaemia

correction and/or the use of erythropoietin towards the course of the underlying

disease, to find out if a combination therapy with erythropoietin and iron may

be beneficial in ACD and to define therapeutic end-points.

The anaemia of chronic disease

http://bmj.bmjjournals.com/cgi/content/full/322/7290/811

Best regards,

Alison

http://www.alisonashwell.com

mailto:alison.ashwell@...

new work uploaded

http://www.artwanted.com/alisonashwell

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