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ANEMIA POR ENFERMEDADES CRONICAS
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Etiologia, factores de riesgo, clasificaciones, diagnostico, manifestaciones clinicas y tratamiento
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ANEMIA POR ENFERMEDADES CRÓNICAS2da causa de anemia más común
DM, HAS, VIH, Cáncer
Normocítica- normocrómica
En algunas personas hipocrómica-microcítica
ETIOPATOGENIA
● Problema en el reciclado del hierro
● Disminución de utilización de hierro
- Hiposideremia → Disminucion de hierro → Macrofagos no estan
reciclando ese hierro por haber enfermedad crónica, macrofagos
estan comabtiendo la otrra enfermedad
- Macrofago no utilizan hierro en SRE → No pasa a la sangre
● Mediado por hepcidina
- Disminuye captación por intestino
● Vida media de eritrocitos disminuida
- Por sustancias tóxicas que llegan a médula ósea y suprimen
hematopoyesis → IFN gamma, FNT alfa
- Si hay estado inflamatorio crónico, suprimen eritropoyesis para
promover leucopoyesis → “Desviación a la izquierda”
CLÍNICA
● Sindrome anemico general
- Astenia
- Irritabilidad
- Palpitaciones
- Mareos
- Cefalea
- Disnea
● + Clínica de enfermedad crónica
DIAGNÓSTICO
● Normo-Normo
● Hipo-Micro
Diferencia entre ferropénica y por enfermedades crónicas
● Ferritina sérica → ALTA → Enf crónica
● Ferritina sérica → baja → Ferropénica
Transferrina sérica → normal o disminuida (capacidad de fijación de hierro)
Indice de Distribucion de Hematies (IDH) → Normal/anisocitosis
Médula ósea → Aumentado
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