Abstract
SummaryIron deficiency and immune activation are the two most frequent causes of anemia, both of which are based on disturbances of iron homeostasis. Iron deficiency anemia results from a reduction of the body’s iron content due to blood loss, inadequate dietary iron intake, its malabsorption, or increased iron demand. Immune activation drives a diversion of iron fluxes from the erythropoietic bone marrow, where hemoglobinization takes place, to storage sites, particularly the mononuclear phagocytes system in liver and spleen. This results in iron-limited erythropoiesis and anemia. This review summarizes current diagnostic and pathophysiological concepts of iron deficiency anemia and anemia of inflammation, as well as combined conditions, and provides a brief outlook on novel therapeutic options.
Highlights
Differential diagnosis and mechanisms of anemia of inflammationReceived: 19 January 2016 / Accepted: 30 May 2016 / Published online: 24 August 2016
Iron deficiency (ID) can occur in two major forms: absolute and functional ID
Isolated iron deficiency anemia (IDA) can be detected by a complete blood count, and iron status based on the reticulocyte count or reticulocyte production index (RPI), erythrocyte indices, ferritin (FT), and transferrin saturation (TSAT)
Summary
Received: 19 January 2016 / Accepted: 30 May 2016 / Published online: 24 August 2016. Immune activation drives a diversion of iron fluxes from the erythropoietic bone marrow, where hemoglobinization takes place, to storage sites, the mononuclear phagocytes system in liver and spleen. This results in iron-limited erythropoiesis and anemia. Die Eisenmangelanämie beruht auf einer Verminderung des Gesamtkörpereisens infolge von Blutverlust, unzureichender alimentärer Zufuhr oder intestinaler Absorption bzw. In dem vorliegenden Übersichtsartikel werden aktuelle diagnostische und pathophysiologische Konzepte von Eisenmangelanämie, Entzündungsanämie sowie kombinierter Anämie zusammengefasst und ein kurzer Ausblick auf neue Therapieoptionen geboten. Zusammenfassung Eisenmangel und Immunaktivierung sind die zwei häufigsten Ursachen der Anämie. Schlüsselwörter Entzündungsanämie · Anämie bei chronischer Erkrankung · Eisen · Hepcidin · Makrophage
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