Characterized by anemia and evidence of immune system activation.
Anemia is mainly due to decreased red blood cell production; may be aggravated by shortened red blood cell survival.
Commonly found in acute and chronic infections, autoimmune disorders, after major trauma and surgery, and in critical illness.
Physical examination findings are those of the underlying disorder.
Therapeutic approach is primarily treatment of the underlying disorder, though treatment of the anemia itself is sometimes appropriate.
Anemia of chronic disease (ACD) is a common syndrome in which the anemia is due to an inflammation-mediated reduction in red blood cell (RBC) production and sometimes in RBC survival. 
Laboratory studies, which collectively identify the syndrome, typically show normocytic normochromic or microcytic hypochromic anemia, relatively low absolute reticulocyte count, low serum iron, low total iron-binding capacity, low to normal percent transferrin saturation, and elevated ferritin.
Hemophilia and Thrombosis Center
University of North Carolina
AM declares that she has no competing interests.
Dr Alice Ma would like to gratefully acknowledge Dr Damon Houghton, Dr Marco Giovannini, Dr Pasquale Niscola, Dr Karen D. Serrano, and Dr Robert D. Woodson, previous contributors to this topic. DH, MG, PN, KDS, and RDW declare that they have no competing interests.
Professor of Clinical Medicine
Eastern Virginia Medical School
SRL declares that he has no competing interests.
Associate Professor of Medicine
Innsbruck Medical University
CP declares that he has no competing interests.
Department of Medical Oncology
University of Colorado Health Sciences Center
RC declares that he has no competing interests.
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