Anemia de enfermedad crónica

por Rosemarie Tremblay-LeMay MD FRCPC
1 de mayo de 2024

La anemia de enfermedad crónica (ACD) es un tipo de anemia that develops when a person has a long-standing illness that causes inflammation. Anemia means that the number of red blood cells (RBCs) or the amount of hemoglobin in the blood is lower than normal. RBCs are responsible for carrying oxygen from the lungs to the rest of the body and carbon dioxide back to the lungs. They hold onto oxygen and carbon dioxide using a specialized protein called hemoglobin.

¿Qué causa la anemia de las enfermedades crónicas?

Any condition that causes chronic inflammation can lead to ACD. These conditions include prolonged infections (such as HIV or tuberculosis), kidney disease, and cancer. Most of these conditions cause anemia by lowering the level of a protein called erythropoietin (EPO) in the body. EPO is made by the kidneys, and it acts as a signal to tell the bone marrow to make more RBCs. Conditions that cause ACD decrease the amount of EPO made by the kidneys and some can inhibit the response of the bone marrow to EPO, which results in fewer RBCs produced in the bone marrow. Inflamación crónica también puede causar anemia al reducir la cantidad de hierro nuevo absorbido de los alimentos o cómo puede ser utilizado por el cuerpo.

¿Cuáles son los síntomas de la anemia de una enfermedad crónica?

Symptoms of ACD include fatigue, shortness of breath, weakness, dizziness, and chest pain. However, some people with ACD will experience no symptoms, and the condition will be diagnosed only after blood tests are performed for another reason.

¿Cómo prueban los médicos la anemia por enfermedad crónica?

A blood test can be used to test for ACD.  When examined under the microscope, the RBCs usually have normal size (normocytic), although in some cases, they can be smaller than normal (microcytic). The level of ferritin in the blood will be normal or increased, even if the iron stores are decreased. The other iron tests will help determine if there is also iron deficiency, as both ACD and anemia of iron deficiency can happen at the same time.

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