Acute event‐related anaemia

Acute events in medicine often lead to anaemia. Many patients become anaemic not only after surgery but also during sepsis and during their stay in an Intensive Care Unit (ICU). At first sight, this seems the result of blood loss including frequent blood drawing and invasive procedures. But apart from hypoferraemia, the acute event-related anaemia (AERA) bears no resemblance to iron deficiency anaemia. AERA, with high ferritin and low-to-normal transferrin and serum transferrin receptor levels, shares characteristics with the anaemia of chronic disease (ACD) found in patients with infectious diseases, inflammatory disorders such as rheumatoid arthritis and with malignancies (Lee, 1983; Means & Krantz, 1992; Means, 1995; Spivak, 2000). In ACD, inflammatory stimuli influence erythropoiesis and iron metabolism leading to a state of functional iron deficiency: hypoferraemia in the presence of normal iron stores (Lee, 1983; Means & Krantz, 1992; Means, 1995; Weiss et al, 1995). Although different types of acute events will show different accents, temporary/ transient inflammation is a common pathophysiological factor contributing to AERA. This review focuses on the possible mechanisms of AERA with the emphasis on erythropoiesis and iron metabolism and their relationship with inflammation.

[1]  N. Lassen,et al.  Serum iron and operative stress. , 2009, Acta medica Scandinavica.

[2]  H. Dodge,et al.  Rate of blood regeneration after blood loss. , 1953, A.M.A. archives of internal medicine.

[3]  J. Clapp,et al.  Red blood cell survival after prolonged perfusion with a blood pump. , 1966, Transactions - American Society for Artificial Internal Organs.

[4]  Kusserow Bk,et al.  Red blood cell survival after prolonged perfusion with a blood pump. , 1966 .

[5]  M. O'Brien,et al.  Red Cell Survival after Heterograft Valve Surgery , 1968, British medical journal.

[6]  M. G. Kakhetelidze,et al.  [Mechanism of the action of erythropoietin]. , 1970, Problemy gematologii i perelivaniia krovi.

[7]  S. Nitter‐Hauge.  Serum iron, total iron-binding capacity and transferrin following acute myocardial infarction. , 2009, Acta medica Scandinavica.

[8]  A. Konijn,et al.  Ferritin Synthesis in Inflammation: I. PATHOGENESIS OF IMPAIRED IRON RELEASE , 1977, British journal of haematology.

[9]  H. Dinant,et al.  Erythropoiesis and Mean Red‐Cell Lifespan in Normal Subjects and in Patients with the Anaemia of Active Rheumatoid Arthritis , 1978, British journal of haematology.

[10]  P. Venge,et al.  Serum ferritin during inflammation. A study on myocardial infarction. , 2009, Acta medica Scandinavica.

[11]  E. Fitzsimons,et al.  Rapid drop in serum iron concentration in myocardial infarction. , 1980, American journal of clinical pathology.

[12]  E. Stemmer,et al.  Erythrocyte survival following extracorporeal circulation. A question of membrane versus bubble oxygenator. , 1981, Journal of Thoracic and Cardiovascular Surgery.

[13]  G. Ballantyne,et al.  Changes in serum iron and leukocyte count associated with open-heart surgery. , 1983, Clinical chemistry.

[14]  Lee Gr.  The anemia of chronic disease. , 1983, Seminars in hematology.

[15]  D. Rowe,et al.  Changes in Serum Ferritin and other ‘Acute Phase’ Proteins following Major Surgery , 1984, Annals of clinical biochemistry.

[16]  D. Cruickshank,et al.  Acute changes in iron metabolism following myocardial infarction. , 1985, American journal of clinical pathology.

[17]  J. McCord,et al.  Oxygen-derived free radicals in postischemic tissue injury. , 1985, The New England journal of medicine.

[18]  I. Paterson.  A study on the mechanism of the postoperative fall in serum iron concentration. , 1986, The Journal of surgical research.

[19]  D. Zdravkovic.  Changes in serum ferritin following surgical trauma , 1987, European journal of haematology.

[20]  G. Brittenham,et al.  Interleukin 1 administration in mice produces hypoferremia despite neutropenia. , 1988, The Journal of clinical investigation.

[21]  H. Julius,et al.  Decreased iron absorption in patients with active rheumatoid arthritis, with and without iron deficiency. , 1988, Annals of the rheumatic diseases.

[22]  J. Spivak,et al.  Effect of repeated whole blood donations on serum immunoreactive erythropoietin levels in autologous donors. , 1988, JAMA.

[23]  G. Horowitz,et al.  Reducing adult phlebotomy blood loss with the use of pediatric-sized blood collection tubes. , 1989, American journal of clinical pathology.

[24]  O. Garden,et al.  Changes in iron, zinc, and copper concentrations in serum and in their binding to transport proteins after cholecystectomy and cardiac surgery. , 1989, Clinical chemistry.

[25]  P. Furmanski,et al.  In vivo hematopoietic effects of recombinant interleukin-1 alpha in mice: stimulation of granulocytic, monocytic, megakaryocytic, and early erythroid progenitors, suppression of late-stage erythropoiesis, and reversal of erythroid suppression with erythropoietin. , 1989, Blood.

[26]  M. Brennan,et al.  The reversal of increased gluconeogenesis in the tumor-bearing rat by tumor removal and food intake. , 1989, Surgery.

[27]  G. Moss,et al.  Perioperative recombinant human erythropoietin. , 1989, Surgery.

[28]  L. Moldawer,et al.  Cachectin/tumor necrosis factor‐α alters red blood cell kinetics and induces anemia in vivo , 1989, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[29]  P. Furmanski,et al.  In vivo hematopoietic effects of recombinant interleukin-1 alpha in mice: stimulation of granulocytic, monocytic, megakaryocytic, and early erythroid progenitors, suppression of late-stage erythropoiesis, and reversal of erythroid suppression with erythropoietin. , 1989, Blood.

[30]  J. Brock,et al.  Induction of hypoferremia and modulation of macrophage iron metabolism by tumor necrosis factor. , 1989, Laboratory investigation; a journal of technical methods and pathology.

[31]  G. Moss,et al.  Treatment of acute postoperative anemia with recombinant human erythropoietin. , 1989, The Journal of trauma.

[32]  P. Pootrakul,et al.  Intact transferrin receptors in human plasma and their relation to erythropoiesis. , 1990, Blood.

[33]  O. Nielsen,et al.  Erythropoietin deficiency in acute tubular necrosis , 1990, Journal of internal medicine.

[34]  P. Furmanski,et al.  In vivo suppression of erythropoiesis by tumor necrosis factor-alpha (TNF-alpha): reversal with exogenous erythropoietin (EPO). , 1990, Experimental hematology.

[35]  H. Munro,et al.  Translational control during the acute phase response. Ferritin synthesis in response to interleukin-1. , 1990, The Journal of biological chemistry.

[36]  W. Fraser,et al.  Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. , 1990, Clinical science.

[37]  G. Bartosz.  Erythrocyte Membrane Changes during Aging in Vivo , 1990 .

[38]  G. Moss,et al.  Erythropoietin deficiency after coronary artery bypass procedures. , 1991, The Annals of thoracic surgery.

[39]  F. Torti,et al.  Tumor necrosis factor-alpha and interleukin 1-alpha regulate transferrin receptor in human diploid fibroblasts. Relationship to the induction of ferritin heavy chain. , 1991, The Journal of biological chemistry.

[40]  C. Salvarani,et al.  The role of interleukin 1, erythropoietin and red cell bound immunoglobulins in the anaemia of rheumatoid arthritis. , 1991, Clinical and experimental rheumatology.

[41]  M. Goldberg,et al.  Effect of inflammatory cytokines on hypoxia-induced erythropoietin production. , 1992, Blood.

[42]  S. Kyo,et al.  Effect of Human Recombinant Erythropoietin on Reduction of Homologous Blood Transfusion in Open‐Heart Surgery: A Japanese Multicenter Study , 1992, Circulation.

[43]  J. Cook,et al.  Serum transferrin receptor distinguishes the anemia of chronic disease from iron deficiency anemia. , 1992, The Journal of laboratory and clinical medicine.

[44]  D. Kwiatkowski,et al.  Systemic cytokine response after major surgery , 1992, The British journal of surgery.

[45]  S. Krantz,et al.  Progress in understanding the pathogenesis of the anemia of chronic disease. , 1992, Blood.

[46]  R. Bone.  Sepsis and coagulation. An important link. , 1992, Chest.

[47]  A. Zauber,et al.  Iron supplementation after femoral head replacement for patients with normal iron stores. , 1992, JAMA.

[48]  M. Goldberg,et al.  EFFECT OF INFLAMMATORY CYTOKINES ON HYPOXIA-INDUCED ERYTHROPOIETIN PRODUCTION , 1992 .

[49]  Effectiveness of perioperative recombinant human erythropoietin in elective hip replacement , 1993, The Lancet.

[50]  J. Dale,et al.  Phlebotomy--a minimalist approach. , 1993, Mayo Clinic proceedings.

[51]  G. Hempelmann,et al.  Platelet function in critically ill patients. , 1994, Chest.

[52]  J. Spivak,et al.  Serum immunoreactive erythropoietin during the perioperative period. , 1994, Surgery.

[53]  M. Tryba.  [Stress bleeding. 1. Pathogenesis, clinical picture and therapy]. , 1994, Der Anaesthesist.

[54]  Risk factors for gastrointestinal bleeding in critically ill patients , 1994 .

[55]  Y. Niitsu,et al.  Interleukin‐6 enhances hepatic transferrin uptake and ferritin expression in rats , 1994, Hepatology.

[56]  J. Gutteridge,et al.  Lipid peroxidation and antioxidants as biomarkers of tissue damage. , 1995, Clinical chemistry.

[57]  D. Fuchs,et al.  Linkage of cell-mediated immunity to iron metabolism. , 1995, Immunology today.

[58]  R. Means.  Pathogenesis of the anemia of chronic disease: A cytokine‐mediated anemia , 1995, Stem cells.

[59]  R. Kraaijenhagen,et al.  Post‐operative erythropoiesis is limited by the inflammatory effect of surgery on iron metabolism , 1995, European journal of clinical investigation.

[60]  W. Wiesmann,et al.  Iron status following trauma, excluding burns , 1996, The British journal of surgery.

[61]  J. Rogers.  Ferritin translation by interleukin-1and interleukin-6: the role of sequences upstream of the start codons of the heavy and light subunit genes. , 1996, Blood.

[62]  B. Krafte-Jacobs,et al.  Circulating erythropoietin and interleukin-6 concentrations increase in critically ill children with sepsis and septic shock* , 1996, Critical care medicine.

[63]  J. Rogers.  Ferritin translation by interleukin-6: the role of sequences upstream of the start codons of the heavy and light subunit genes , 1996 .

[64]  R. Motson,et al.  Incidence of third‐degree perineal tears in labour and outcome after primary repair , 1996, The British journal of surgery.

[65]  M. Ritter,et al.  The effects of recombinant human erythropoietin on perioperative transfusion requirements in patients having a major orthopaedic operation. The American Erythropoietin Study Group. , 1996, The Journal of bone and joint surgery. American volume.

[66]  Faris Pm,et al.  The Effects of Recombinant Human Erythropoietin on Perioperative Transfusion Requirements in Patients Having a Major Orthopaedic Operation* , 1996, The Journal of bone and joint surgery. American volume.

[67]  W. Jelkmann,et al.  Serum erythropoietin levels in patients with sepsis and septic shock , 1996, European journal of haematology.

[68]  H. Kern,et al.  Recombinant human erythropoietin: effect on the functional performance of anemic orthopedic patients. , 1996, Archives of physical medicine and rehabilitation.

[69]  J. Boldt.  Coagulation abnormalities in the OR and on the ICU. , 1996, Acta anaesthesiologica Scandinavica. Supplementum.

[70]  D. Fuchs,et al.  Erythropoietin response is blunted in critically ill patients. , 1997, Intensive care medicine.

[71]  M. Zimpfer,et al.  High-dose recombinant human erythropoietin stimulates reticulocyte production in patients with multiple organ dysfunction syndrome. , 1998, The Journal of trauma.

[72]  K. Gubler,et al.  Efficacy of recombinant human erythropoietin in the critically ill patient: A randomized, double-blind, placebo-controlled trial , 1998 .

[73]  A. van de Wiel,et al.  Iron metabolism and erythropoiesis after surgery , 1998, The British journal of surgery.

[74]  J. V. D. van der Meer,et al.  Elective orthopedic surgery, a model for the study of cytokine activation and regulation. , 1998, Cytokine.

[75]  J. Spivak.  The blood in systemic disorders , 2000, The Lancet.

[76]  A. van de Wiel,et al.  Total hip replacement surgery does not influence RBC survival , 2000, Transfusion.

[77]  A. van de Wiel,et al.  Response of erythropoiesis and iron metabolism to recombinant human erythropoietin in intensive care unit patients , 2000, Critical care medicine.