Anemia of chronic disease: an adaptive response?

August 11, 2008

The anemia of chronic disease may be a beneficial, adaptive response to the underlying disease, rather than a negative effect of the illness, postulates an analysis article in CMAJ, http://www.cmaj.ca/press/pg333.pdf.

The authors argue that anemia may be beneficial to patients with inflammatory disease, and advocate restraint in treating mild to moderate forms of anemia.

"The general assumption is that anemia is a disorder and that patients would be better off without it," state the authors.

However, they suggest that anemia of chronic disease has the characteristics of an adaptive physiologic response, and their review of the literature shows that mortality appears to increase when treatment, given to raise hemoglobin levels, overrides mild to moderate anemia of chronic disease. They call for better characterization of the cause of individual patients' anemia in future trials of anemia treatment, and careful monitoring of adverse outcomes, including mortality, if patients with anemia of chronic disease are included in such trials.
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Canadian Medical Association Journal

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