Pathophysiologic mechanisms of anemia of chronic disease.

Anemia of chronic disease (ACD) is a prevalent condition commonly observed in patients with chronic infections, cancer, trauma, and inflammatory disorders. In this article, Dr Andrews examines new research findings that enhance the understanding of the pathophysiologic mechanisms of ACD. After a brief review of iron homeostasis and a look at ACD in a historical context, she explores the significance of hepcidin, a recently discovered hormone involved in iron metabolism, and discusses a new hypothesis that connects hepcidin to the pathogenesis of ACD. Dr Andrews also examines the link between ACD and hereditary hemochromatosis, 2 disorders that on the surface may seem quite different but have in common the involvement of hepcidin in their pathogenesis.