<unk>  is defined by hemoglobin (Hb) concentration * < 13.0 g/dL (130 g/L) in males * < 11.5 g/dL (115 g/L) in females In response to inflammatory cytokines, increasingly IL-6, the liver produces increased amounts of hepcidin. Hepcidin in turn causes increased internalisation of ferroportin molecules on cell membranes which prevents release from iron stores. Inflammatory cytokines also appear to affect other important elements of iron metabolism, including decreasing ferroportin expression, and probably directly blunting erythropoiesis by decreasing the ability of the bone marrow to respond to erythropoietin. Before the recent discovery of hepcidin and its function in iron metabolism,<unk>  was seen as the result of a complex web of inflammatory changes. Over the last few years, however, many investigators have come to feel that hepcidin is the central actor in producing<unk>  of<unk>  inflammation. Hepcidin provides a unifying explanation for the condition, and more recent descriptions of human iron metabolism and hepcidin function reflect this view. In addition to effects of iron sequestration, inflammatory cytokines promote the production of white blood cells. Bone marrow produces both white blood cells and red blood cells from the same precursor stem cells. Therefore, the upregulation of white blood cells causes fewer stem cells to differentiate into red blood cells. This effect may be an important additional cause for the decreased erythropoiesis and red blood cell production seen in<unk>  of inflammation, even when erythropoietin levels are normal, and even aside from the effects of hepcidin. Nonetheless, there are other mechanisms that also contribute to the lowering of hemoglobin levels during inflammation: (i) Inflammatory cytokines suppress the proliferation of erythroid precursors in the bone marrow.; (ii) inflammatory cytokines inhibit the release of erythropoietin (EPO) from the kidney; and (iii) the survival of circulating red cells is shortened. In the short term, the overall effect of these changes is likely positive: it allows the body to keep more iron away from bacterial pathogens in the body, while producing more immune cells to fight off infection. Almost all bacteria depend on iron to live and multiply. However, if inflammation continues, the effect of locking up iron stores is to reduce the ability of the bone marrow to produce red blood cells. These cells require iron for their massive amounts of hemoglobin which allow them to transport oxygen. Because<unk>  can be the result of non-infective causes of inflammation, future research is likely to investigate whether hepcidin antagonists might be able to treat this problem.<unk>  may also be due to neoplastic disorders and non-infectious inflammatory<unk> s. Neoplastic disorders include Hodgkin<unk>  and lung and breast carcinoma, while non-infectious inflammatory<unk> s include celiac<unk> , rheumatoid arthritis, systemic lupus erythematosus, scleroderma and dermatomyositis.<unk> , as it is now understood, is to at least some degree separate from the<unk>  seen in kidney failure in which<unk>  results from reduced production of erythropoietin, or the<unk>  caused by some drugs (like AZT, used to treat HIV infection) that have the side effect of inhibiting erythropoiesis. In other words, not all<unk>  seen in people with<unk><unk>  should be diagnosed as<unk> . On the other hand, both of these examples show the complexity of this diagnosis: HIV infection itself can produce<unk> , and kidney failure can lead to inflammatory changes that also can produce<unk> .
Anemia of chronic disease
Anemia in pregnancy
Transfusion-dependent anemia
Acquired hemolytic anemia
Heparin-induced thrombocytopenia
Hemoglobinemia
Sideroblastic anemia
EEM syndrome