Anemia of Inflammatory Disease
Johanna L. Watson • Gary P. Carlson
A depression anemia associated with characteristic disturbances of iron metabolism is often found in animals with conditions that result in a chronic inflammatory response.13,14 These conditions include chronic internal or cutaneous infections, infectious diseases, or immune-mediated processes that result in chronic inflammation, severe traumatic injury or fractures, and active malignant neoplasia.
The anemia tends to be mild, slowly progressive, and of little clinical consequence. Clinical signs relate to the primary disease process, and hematologic features are those of a mild, unresponsive anemia, often with indications of a chronic inflammatory response. Serum iron and iron-binding capacity are decreased, but marrow iron reserves and serum ferritin are increased.14 Anemia in these animals is partially due to a modest decrease in circulating red cell life span, but it is primarily caused by major alterations in iron metabolism and depressed bone marrow response to the anemia. These alterations represent part of the body's response to inflammation, which includes release of interleukins and other mediators and production and release of acute-phase proteins from the liver. The body sequesters iron from the circulation into storage forms, primarily in the liver and bone marrow, where it is retained and relatively unavailable for erythropoiesis. This general reaction may play a protective role by denying readily available iron to potential bacterial pathogens that require iron for growth. Iron supplementation is not indicated to treat the anemia of chronic inflammation; therapeutic effort should be directed at resolving the primary disease process.
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