Emootje
Senior Member
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- 356
- Location
- The Netherlands
Hurwitz study shows that patients with severe CFS have a 13.26% shortage of red blood cell volume (RBCV) and patients with non-severe CFS have a 5.82% shortage of RBCV. I think that this anemia could be explained by the inhibitory effect of cytokines on the erythropoiesis.
Anemia of chronic disease is is a form of anemia seen in chronic illness, e.g. from chronic infection, chronic immune activation, or malignancy.
Weiss and Goodnough did an excellent review on the anemic effects of inflammation.
http://www.med.unc.edu/medclerk/medselect/files/anemia2.pdf
They describe the effects of different kinds of cytokines on iron metabolism and EPO production/erythropoiesis:
TNF alfa:
*Degradation erythrocytes?
*EPO production?
*Erythropoiesis?
Interferon gamma:
*EPO production?
*Erythropoiesis?
*Ferroportin-1?
*Divalent metal transporter-1 (DMT-1)?
Interleukin-1:
*EPO production?
*Erythropoiesis?
*Ferritin ?
Interleukin-6:
*Ferritin?
*Hepcidin? >
Fe2+ absorption?
Ferroportin-1?
Erythropoiesis?
Interleukin-10:
*Ferritin?
*Transferrin-receptor expression?
So if you have low iron or low transferrin or high ferritin or high hepcidin, you could have an anemia of chronic disease!
Note: In ME/CFS hemoglobin and hematocrit are unreliable markers for anemia. The only way to make sure you are anemic is by a red blood cell volume determination.
Anemia of chronic disease is is a form of anemia seen in chronic illness, e.g. from chronic infection, chronic immune activation, or malignancy.
Weiss and Goodnough did an excellent review on the anemic effects of inflammation.
http://www.med.unc.edu/medclerk/medselect/files/anemia2.pdf
They describe the effects of different kinds of cytokines on iron metabolism and EPO production/erythropoiesis:
TNF alfa:
*Degradation erythrocytes?
*EPO production?
*Erythropoiesis?
Interferon gamma:
*EPO production?
*Erythropoiesis?
*Ferroportin-1?
*Divalent metal transporter-1 (DMT-1)?
Interleukin-1:
*EPO production?
*Erythropoiesis?
*Ferritin ?
Interleukin-6:
*Ferritin?
*Hepcidin? >
Fe2+ absorption?
Ferroportin-1?
Erythropoiesis?
Interleukin-10:
*Ferritin?
*Transferrin-receptor expression?
So if you have low iron or low transferrin or high ferritin or high hepcidin, you could have an anemia of chronic disease!
Note: In ME/CFS hemoglobin and hematocrit are unreliable markers for anemia. The only way to make sure you are anemic is by a red blood cell volume determination.