Анемия хронических заболеваний
2014
The anemia originating under infectious inflammatory processes, non-infectious inflammatory diseases, tumors is called “anemia under chronic diseases” to emphasize the role of main disease in its pathogenesis. The rate of occurrence of anemia under certain diseases reaches 100%. But, in these situations, for all that diversity of pathogenic mechanisms of anemia, one of the main mechanisms is considered the redistribution of iron into cells of macrophage system activating under various inflammatory (infectious and non-infectious) or neoplastic processes. The anemia under chronic diseases by their prevalence takes second place after iron-deficiency anemia. The prevalence of anemia under chronic diseases in old and senile age varies from 2.9% to 61% in males and from 3.3% to 41% in females. In young and mature age, anemia under chronic diseases is more often detected in females. In hospitalized patients of old age its rate goes up to 36-80% whereas in out-patients it goes to5-14%. Among patients with systemic diseases of connective tissue anemia occurs almost in half of patients and at that anemia under chronic diseases is prevailing. The diagnostic criteria of anemia under chronic diseases are indicated in details. The main mode of correction of anemia in this category of patients is the treatment of active inflammatory process. This treatment includes antibacterial therapy considering character of supposed of verified infection agent, basic and antiinflammatory therapy of rheumatoid diseases, surgery treatment under corresponding indications (abscess of abdominal cavity, purulent pyelonephritis, etc.). In these situations, prescription of iron preparations, vitamin B12 as usually is inefficient and only delaying timely detection of main cause of anemia and onset of corresponding therapy. The picking out of anemia under chronic diseases as a separate pathogenic alternative and awareness about it both have important value in view of matching of this alternative to iron-deficiency anemia and certain sideroblastic anemias although essence and therapeutic approaches under these anemias are different.
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