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Anemia of chronic disease


Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia.

Anemia of chronic disease is anemia that is found in people with certain long-term (chronic) medical conditions.

Alternative Names

Anemia of inflammation; AOCD; ACD


Anemia is a lower-than-normal number of red blood cells in the blood. Some conditions can lead to anemia of chronic disease include:

  • Autoimmune disorders, such as Crohn disease, systemic lupus erythematosus, rheumatoid arthritis, and ulcerative colitis
  • Cancer, including lymphoma and Hodgkin disease
  • Chronic kidney disease
  • Long-term infections, such as bacterial endocarditis, osteomyelitis (bone infection), HIV/AIDS, hepatitis B or hepatitis C


Anemia of chronic disease is often mild. You may not notice any symptoms.

When symptoms occur, they may include:

  • Feeling weak or tired
  • Headache
  • Paleness
  • Shortness of breath

Exams and Tests

The doctor will perform a physical exam.

Anemia may be the first symptom of a serious illness, so finding its cause is very important.

Tests that may be done to diagnose anemia or rule out other causes include:

  • Hemoglobin level
  • Red blood count
  • Reticulocyte count
  • Serum ferritin level
  • Serum iron level
  • Other blood tests


Anemia is often mild enough that it does not need treatment. It will likely get better when the disease that is causing it is treated.

The condition is rarely severe enough to need a blood transfusion.

Iron supplements may sometimes be used, but only for patients whose iron levels are low. Taking iron pills when your body does not need them can lead to serious medical problems. Do not take iron pills before talking with your health care provider first.

Outlook (Prognosis)

The anemia will improve when the disease that is causing it is treated.

Possible Complications

Discomfort from symptoms is the main complication in most cases. Anemia may lead to a higher risk of death in patients with heart failure.

When to Contact a Medical Professional

Call your health care provider if you have a chronic disorder and you develop symptoms of anemia.



Little JA, Benz Jr EJ, Gardner LB. Anemia of chronic diseases. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al., eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 35.

Nicklaus Children's Hospital

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