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Inflammatory anemia and elderly

Lucia De Franceschi, Achille Iolascon, Ali Taher, Maria Domenica Cappellini
Global burden disease studies point out that one of the top cause-specific anemias is iron deficiency (ID). Recent advances in knowledge of iron homeostasis have shown that fragile patients are a new target population in which the correction of ID might impact their morbidity, mortality and quality of life. We did a systematic review using specific search strategy, carried out the review of PubMed database, Cochrane Database of systemic reviews and international guidelines on diagnosis and clinical management of ID from 2010 to 2016...
May 18, 2017: European Journal of Internal Medicine
Racha Halawi, Hassan Moukhadder, Ali Taher
Anemia in the elderly is a common finding that is associated with a poorer quality of life, worse outcomes, and increased mortality. While this entity is frequently overlooked, there is often an underlying cause that is correctable. Areas covered: In this review, we shed light on the prevalence of anemia in the elderly population, review the most common causes, particularly iron deficiency anemia and anemia of chronic disease, and describe the available treatment modalities. When a clear etiology for the anemia is ruled-out, the term unexplained anemia may be utilized; while still an under-explored field, one of the underlying pathophysiological mechanisms appears to be associated with an age-related inflammatory process...
April 2017: Expert Review of Hematology
E Frangos, A Trombetti, C E Graf, V Lachat, N Samaras, U M Vischer, D Zekry, R Rizzoli, F R Herrmann
BACKGROUND: Anemia and malnutrition are highly prevalent, frequently concomitant and associated with negative outcomes and mortality in the elderly. OBJECTIVES: To evaluate the association between these two entities, and test the hypothesis that protein-energy deficit could be etiology of anemia. DESIGN: Prospective case-control study. SETTING: Geriatric and Rehabilitation Hospital, Geneva University Hospitals, Switzerland...
2016: Journal of Nutrition, Health & Aging
Gabriele Röhrig
Anemia and frailty are two common findings in geriatric patients and have been shown to be associated with poor outcomes in this patient group. Recent studies have contributed to the growing evidence of a possible association with the age-related chronic inflammatory status known as "inflammaging". These findings do not only give a better insight into the pathogenesis of anemia in frailty, but also offer new treatment options. The present article focuses on this assumed association between anemia, frailty, and inflammaging and summarizes current management options for anemia in frail patients...
2016: Clinical Interventions in Aging
Ewelina Lukaszyk, Mateusz Lukaszyk, Ewa Koc-Zorawska, Anna Bodzenta-Lukaszyk, Jolanta Malyszko
PURPOSE: The aim of the study was to assess GDF-15 and iron status in patients in early stages of chronic kidney disease with a particular emphasis on elderly population in association of classic iron status parameters with novel iron homeostasis biomarkers and inflammatory parameters. METHODS: Serum concentrations of GDF-15, iron (Fe), transferrin saturation, soluble transferrin receptor (sTfR), hepcidin, high-sensitive C-reactive protein (hsCRP), interleukin 6 (IL-6), and hemoglobin were measured in 56 patients ≥65 years of age and in 31 <65 years of age...
June 2016: International Urology and Nephrology
Raoul Karfo, Laila Benchekroun, Alban Zohoun, Layachi Chabraoui
The discovery of a monoclonal immunoglobulin is usually witnessed a malignant lymphoproliferative disease, but sometimes it is a transient event during viral, bacterial or fungal infections and during an inflammatory syndrome. Achieving electrophoresis performed in an elderly patient aged 55 with anemia to 63 g/L hemoglobin showed a consistent profile with intense inflammatory syndrome and chronic atypical with elevated C-reactive protein (CRP) greater than 300 mg/L (normal values: 0-8 mg/L) associated with the presence of two thin appearance monoclonal migrating bands in gamma position...
July 2015: Annales de Biologie Clinique
M Domenica Cappellini, Irene Motta
Anemia is a global public health problem affecting both developing and developed countries at all ages. According to the World Health Organization (WHO), anemia is defined as hemoglobin (Hb) levels <12.0 g/dL in women and <13.0 g/dL in men. However, normal Hb distribution varies not only with sex but also with ethnicity and physiological status. New lower limits of normal Hb values have been proposed, according to ethnicity, gender, and age. Anemia is often multifactorial and is not an independent phenomenon...
October 2015: Seminars in Hematology
G Metzgeroth, J Hastka
Hypochromic-microcytic anemias are characterized by a hemoglobin deficiency of the erythrocytes. The main reason for the insufficient hemoglobin synthesis is, with exception of thalassemia and a few other rare conditions, primarily a disorder of iron metabolism. Differential diagnostic considerations are focused on iron deficiency anemia, with approximately 80% the most common form of anemia worldwide. Iron deficiency anemia shows a particularly high prevalence in developing countries, but is also in industrialized Western countries the most common cause of anemia...
September 2015: Der Internist
Alexis Mohebi, Tristan Cudennec
Anaemia is particularly common amongthe elderly population. It is necessary, with the aid of the mean glomerular volume, to determine if it is microcytic, normocytic or macrocytic. Similarly, the level of reticulocytes indicates whether the anaemia is regenerative or non-regenerative. A systematic approach helps to identify the causes of this low haemoglobin level. As always in the elderly, it is necessary to be aware of their inflammatory status and estimate the iatrogenic risk.
March 2015: Soins. Gérontologie
P Anyfanti, A Pyrpasopoulou, A Triantafyllou, S Chatzimichailidou, S Aslanidis, S Douma
BACKGROUND: The overall world prevalence of rheumatoid arthritis (RA) ranges from 0.5-1.0%. The annual incidence of RA in most European countries ranges from roughly 0.4 to >2.5 per 1,000 adults, increasing with age. A significant proportion of newly diagnosed cases will evolve into true erosive RA. METHODS: The aim of this cohort study was to study the characteristics of new developing, acute (<1 year), rheumatoid arthritis in an elderly (>65 years) population; its presenting features, accompanying manifestations and laboratory findings...
July 2014: Hippokratia
Richard Češka
Anaemia is one of the most common diseases. Worldwide affects up to 25% of the population. Anaemia with iron deficiency (Fe) is the leading one. It is not surprising that iron deficiency mainly affects women. Generally, anaemia is one of the major problems in every department of internal medicine. There is no ambition to provide a comprehensive review of the diagnosis and treatment of anaemia. The aim is to point out the common (but sometimes neglected) facts from daily practice in internal department and on the other hand, to highlight the news in the treatment focusing on parenteral Fe...
December 2014: Vnitr̆ní Lékar̆ství
W Chebbi, S Arfa, B Zantour, M H Sfar
PURPOSE: Iron deficiency anemia is a common hematological abnormality in the older people. The aim of this study is to determine the clinical and biological characteristics and causes of the iron deficiency anemia in elderly patients. PATIENTS AND METHODS: We performed a retrospective study of 102 patients aged 65 years and older who were hospitalized for iron deficiency anemia in the internal Medicine Department of Mahdia University Hospital, over a 8-year period (January 2005 to December 2012)...
September 2014: Revue Médicale de Bruxelles
Yan Liu, Wei Zhang, Zhaohui Zhu, Xinping Tian, Huanling Wang
OBJECTIVE: To evaluate the clinical diagnostic contribution of (18)F-FDG PET/CT in giant cell arteritis with initial presentation as fever of unknown origin (FUO) . METHODS: Eight cases with initial presentation as FUO diagnosed with the contribution of PET/CT were retrospectively studied in Peking Union Medical College Hospital. The radiologic manifestations of PET/CT were analyzed. RESULTS: Eight patients (4 men and 4 women) with average (63 ± 7) years (range from 55-75 years) were included in our study based on the criteria...
September 2014: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Elísio Costa, João Fernandes, Sandra Ribeiro, José Sereno, Patrícia Garrido, Petronila Rocha-Pereira, Susana Coimbra, Cristina Catarino, Luís Belo, Elsa Bronze-da-Rocha, Helena Vala, Rui Alves, Flávio Reis, Alice Santos-Silva
Our aim was to contribute to a better understanding of the pathophysiology of anemia in elderly, by studying how aging affects renal function, iron metabolism, erythropoiesis and the inflammatory response, using an experimental animal model. The study was performed in male Wistar, a group of young rats with 2 months age and an old one with 18 months age. Old rats presented a significant higher urea, creatinine, interferon (INF)-gamma, ferritin and soluble transferrin receptor serum levels, as well as increased counts of reticulocytes and RDW...
December 2014: Aging and Disease
Gabriele Röhrig, Tilmann Steinmetz, Jürgen Stein, Tabea Geisel, Garth Virgin, Roland Schaefer, Matthias Bach, Ralf-Joachim Schulz
BACKGROUND: Anemia in the elderly is a common clinical finding. Prevalence in hospitalized geriatric patients approximates up to 40% presenting as iron deficiency anemia associated with absolute iron deficiency, anemia of chronic disease associated with functional iron deficiency or unexplained anemia. In patients with functional iron deficiency oral iron substitution is ineffective due to elevated hepcidin levels, such as in renal anemia. In these patients intravenous iron substitution represents a cornerstone...
July 24, 2014: MMW Fortschritte der Medizin
João Carlos Silva, Zélia Vieira de Moraes, Conceição Silva, Silvia de Barros Mazon, Maria Elena Guariento, Anita Liberalesso Neri, André Fattori
Frailty and anemia in the elderly appear to share a common pathophysiology associated with chronic inflammatory processes. This study uses an analytical, cross-sectional, population-based methodology to investigate the probable relationships between frailty, red blood cell parameters and inflammatory markers in 255 community-dwelling elders aged 65 years or older. The frailty phenotype was assessed by non-intentional weight loss, fatigue, low grip strength, low energy expenditure and reduced gait speed. Blood sample analyses were performed to determine hemoglobin level, hematocrit and reticulocyte count, as well as the inflammatory variables IL-6, IL-1ra and hsCRP...
November 2014: Archives of Gerontology and Geriatrics
Liliana Garneata, Oana Slusanschi, Elena Preoteasa, Alexandra Corbu-Stancu, Gabriel Mircescu
BACKGROUND: Periodontal disease (PDD) was associated with inflammation, malnutrition, and higher mortality in hemodialysis (HD) patients. STUDY DESIGN AND OBJECTIVE: Cross-sectional observational study, aiming to assess the prevalence of PDD and the possible relationship among PDD, inflammation, and malnutrition in HD patients. SETTINGS AND PARTICIPANTS: Single HD center, 263 patients (age: 57.4 ± 12.3 years; 60% males; HD vintage 6.6 ± 4...
January 2015: Journal of Renal Nutrition
Chris P Verschoor, Jennie Johnstone, Jamie Millar, Robin Parsons, Alina Lelic, Mark Loeb, Jonathan L Bramson, Dawn M E Bowdish
BACKGROUND: Circulating myeloid cells are important mediators of the inflammatory response, acting as a major source of resident tissue antigen presenting cells and serum cytokines. They represent a number of distinct subpopulations whose functional capacity and relative concentrations are known to change with age. Little is known of these changes in the very old and physically frail, a rapidly increasing proportion of the North American population. DESIGN: In the following study the frequency and receptor expression of blood monocytes and dendritic cells (DCs) were characterized in a sample of advanced-age, frail elderly (81-100 yrs), and compared against that of adults (19-59 yrs), and community-dwelling seniors (61-76 yrs)...
2014: PloS One
Lucile Capuron, Simon Geisler, Katharina Kurz, Friedrich Leblhuber, Barbara Sperner-Unterweger, Dietmar Fuchs
Immune activation not only accompanies inflammation in various disorders including infections, autoimmune syndromes and cancer, but it also represents a characteristic feature of ageing. Immune deviations which are most widely expressed in the elderly include increased neopterin production and tryptophan breakdown. These biochemical events result from the activation of the immune system and are preferentially triggered by pro-inflammatory stimuli, such as the Th1-type cytokine interferon-γ. They seem to play a role in the development of several age-related disorders and might be involved in the pathogenesis of common symptoms, including neurobehavioral disorders (e...
2014: Current Pharmaceutical Design
Amanda J Redig, Nancy Berliner
Anemia is a common feature of HIV-related disease and has been uniformly demonstrated to be an independent predictor of morbidity and mortality. Although anemia often responds to combination antiretroviral therapy, many patients remain anemic despite therapy and such persistent anemia continues to negatively affect prognosis regardless of drug response. Anemia is also a common feature of normal aging. We postulate that the pathophysiology of anemia in HIV, especially that which persists in the face of combination antiretroviral therapy, is a reflection of underlying proinflammatory pathways that are also thought to contribute to anemia in the elderly, as well as other age-related chronic diseases such as cardiovascular disease and chronic obstructive pulmonary disease...
2013: Hematology—the Education Program of the American Society of Hematology
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