D63
DESCRIPTION
Anaemia caused by chronic infection or disease. This may be due to interference with nutrient supply or suppression of haemopoiesis. Iron may be trapped in the reticuloendothelial system resulting in relative iron deficiency.
Symptomatic anaemia may manifest with tachypnoea, tachycardia not attributable to other causes and heart failure.
DIAGNOSTIC CRITERIA
Clinical
- Pallor, fatigue;
- Features of malnutrition or chronic infection e.g. TB, HIV, chronic renal failure; or
- Autoimmune disease may be present.
Investigations
- Haemoglobin low with usually normocytic, normochromic red cells (may be microcytic).
- TST, chest X-ray and renal function tests.
GENERAL AND SUPPORTIVE MEASURES
- Emphasise a nutritionally balanced diet that is adequate in protein, vitamins and minerals for nutritional rehabilitation.
- Transfuse for symptomatic anaemia only.
MEDICINE TREATMENT
- Treat underlying cause, e.g. TB infection.
- Defer iron treatment until acute diseases are controlled, then provide extra iron (see Anaemia, Iron Deficiency ) and multivitamins.
REFERRAL
- All cases with unresolving anaemia and no cause found.