It is the second most common anemia in the world and the most common in hospitalized patients.
Etiology and Pathogenesis
It develops due to the increase in proinflammatory cytokines (IL-1, TNF, interferon gamma) and hepcidin released in inflammatory diseases (infections, malignancy, rheumatic diseases).
Cytokines suppress erythropoietin and erythropoiesis.
Hepcidin, which increased as a positive phase reactant; It reduces the absorption of iron from the intestines and the release of iron from the stores, resulting in a decrease in serum iron.
Erythrocyte life is shortened.
Lab
It causes normochromic normocytic or hypochromic microcytic anemia.
Both serum iron and serum iron binding capacity are low.
Ferritin is normal/high (positive acute phase reactant).
Serum soluble transferrin receptor level is low.
Inflammation markers such as CRP, fibrinogen, etc. can be detected high.
Treatment
The underlying disease (thus inflammation and cytokine release) should be treated
In symptomatic patients, blood transfusion, erythropoietin therapy and parenteral iron can be administered.
Anemia in Chronic Liver Disease
Acute or chronic blood loss (the most important cause): It is due to a decrease in coagulation factors and platelet count.
Iron deficiency anemia: It is due to chronic varicose veins.
B12 deficiency and folate deficiency: It depends on the nutritional disorder.
Hypersplenism: Pancytopenia and reticulocyto
Zieve syndrome: chronic Liver + Hyperipidemia + Hemolytic anemia
Increase in plasma volume / Dilution
Hypometabolic state anemias
It is characterized by normochromic and normocytic, moderate hypoproliferative anemia.
Serum iron, SDeBK, transferrin saturation, ferritin and storage iron are normal.
Etiology
Endocrine causes (Hypothyroidism, Addison's disease, Pituitary failure, Hyperparathyroidism, Hypogonadism)
Protein-energy malnutrition
liver disease
Etiology and Pathogenesis
It develops due to the increase in proinflammatory cytokines (IL-1, TNF, interferon gamma) and hepcidin released in inflammatory diseases (infections, malignancy, rheumatic diseases).
Cytokines suppress erythropoietin and erythropoiesis.
Hepcidin, which increased as a positive phase reactant; It reduces the absorption of iron from the intestines and the release of iron from the stores, resulting in a decrease in serum iron.
Erythrocyte life is shortened.
Lab
It causes normochromic normocytic or hypochromic microcytic anemia.
Both serum iron and serum iron binding capacity are low.
Ferritin is normal/high (positive acute phase reactant).
Serum soluble transferrin receptor level is low.
Inflammation markers such as CRP, fibrinogen, etc. can be detected high.
Treatment
The underlying disease (thus inflammation and cytokine release) should be treated
In symptomatic patients, blood transfusion, erythropoietin therapy and parenteral iron can be administered.
Anemia in Chronic Liver Disease
Acute or chronic blood loss (the most important cause): It is due to a decrease in coagulation factors and platelet count.
Iron deficiency anemia: It is due to chronic varicose veins.
B12 deficiency and folate deficiency: It depends on the nutritional disorder.
Hypersplenism: Pancytopenia and reticulocyto
Zieve syndrome: chronic Liver + Hyperipidemia + Hemolytic anemia
Increase in plasma volume / Dilution
Hypometabolic state anemias
It is characterized by normochromic and normocytic, moderate hypoproliferative anemia.
Serum iron, SDeBK, transferrin saturation, ferritin and storage iron are normal.
Etiology
Endocrine causes (Hypothyroidism, Addison's disease, Pituitary failure, Hyperparathyroidism, Hypogonadism)
Protein-energy malnutrition
liver disease