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Thread: Iron and the anaemia of chronic disease: a review and strategic recommendations

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    Registered User Sharon Grant's Avatar
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    Iron and the anaemia of chronic disease: a review and strategic recommendations

    Curr Med Res Opin. 2006 Apr;22(4):731-7

    Iron and the anaemia of chronic disease: a review and strategic recommendations.


    Cavill I, Auerbach M, Bailie GR, Barrett-Lee P, Beguin Y, Kaltwasser P, Littlewood T, Macdougall IC, Wilson K.

    Medical School, Cardiff University, UK.

    BACKGROUND: The incidence of anaemia is high in many chronic conditions, yet it often receives little attention. SCOPE/METHODS: A panel of international experts with experience in haematology, nephrology, oncology, rheumatology and pharmacy was convened to prepare strategic guidelines. A focused literature search was conducted after key issues had been identified. A series of recommendations was agreed, backed, wherever possible, by published evidence which is included in the annotations. RECOMMENDATIONS: Anaemia is a critical issue for patients with chronic diseases. Healthcare professionals need to recognise that anaemia is a frequent companion of cancer and chronic conditions such as rheumatoid arthritis and heart failure. It reduces patients' quality of life and can increase morbidity and mortality. Anaemia should be considered as a disordered process in which the rate of red cell production fails to match the rate of destruction which leads eventually to a reduction in haemoglobin concentration; this process is common to all chronic anaemias. The aim of anaemia management should be to restore patient functionality and quality of life by restoring effective red cell production. Blood transfusion can elevate haemoglobin concentration in the short term but does nothing to address the underlying disorder; red cell transfusion is, therefore, not an appropriate treatment for chronic anaemia. Patients with anaemia of chronic disease may benefit from iron therapy and/or erythropoiesis stimulating agents (ESAs). Intravenous iron should be considered since this can be given safely to patients with chronic diseases while intramuscular iron causes unacceptable adverse effects and oral iron has limited efficacy in chronic anaemia. CONCLUSION: The management of anaemia calls for the development of a specialist service together with education of all healthcare professionals and transfer of skills from areas of good practice. Improvement in the management of anaemia requires a fundamental change of attitude from healthcare professionals.

    Publication Types: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16684434&query_hl=12&itool=pubmed_docsum
    Sharon Grant
    Editorial Team

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    My 20 year old son was diagnosed with Ulcerative Colitis nearly 2 years ago and has been experiencing a flare-up since last December. He is being treated with Lialda, Imuran, Prednisone, Immodium and Prilosec but his CBC is now at 7, so his physician recommends an iron infusion. A brother in our local congregation who handles medical treatments where physicians push blood transfusions, recommended Kadlec for an iron cocktail infusion. We have insurance which does not require referrals, but I have no idea which doctor we would need to see for this treatment. Can you recommend one who will work with us to improve the CBC without blood transfusion? Any help would be greatly appreciated. Thank you.
    Sincerely, Helen Blouin-Duncan

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