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5.7.3

Anaemia of Chronic Disease

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 5, Blood and Haematology.

Clinical Description

Anaemia due to chronic inflammation. It is characteristically a normochromic, normocytic anaemia but can also be microcytic.

  • Common causes of anaemia of chronic disorder include:
  • Malignancy ( e.g. Haematological or solid tumours),
  • Autoimmune disorders ( e.g. Rheumatoid arthritis,SLE)
  • Acute or chronic infections, e.g. HIV and TB
  • Chronic kidney disease

Signs and Symptoms

  • Pallor and signs of underlying condition

Investigations

  • Full blood count, Specific tests to exclude causes , HIV test, Urea, Electrolytes and Creatinine, ESR, Sputum for GeneXpert, Chest Xray

Treatment

  • Treat the underlying condition.
  • Transfusion is seldom necessary.
  • Do not treat with iron, folic acid or vitamin B12 unless there is a documented deficiency.

Complications and Referral Criteria

  • Patients not responding to treatment
  • Patients requiring further work up and treatment at tertiary centre

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