DEVELOPMENT MECHANISMS AND CLINICAL SIGNIFICANCE OF ANEMIA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

For a long time, chronic obstructive pulmonary disease (COPD) was associated with polycythemia with chronic hypoxia. Epidemiological studies of recent years show that 17 to 24 % of patients with COPD have anemia and only 6 to 10 % have polycythemia. Anemia in patients with COPD can be caused by concomitant pathology or pathogenetically related to the underlying disease and may be referred to anemia of chronic disease (ACD). Anemia is an independent factor in the severity of dyspnea, reduced tolerance to stress and survival of patients. A high level of hepcidin in the serum of blood, which occurs as a result of systemic inflammation, impairs absorption of iron, and also leads to sequestering of iron in macrophages, plays a key role in the development of ACD. Investigating the mechanisms of occurrence of this anemia and determining the optimal ways of it`s correction can improve the quality of life, reduce the overall cost of treatment and disability. The results of a self-study show that 6.5 % of patients with COPD have iron deficiency anemia and 16.3 % of ACD. Patients with iron deficiency anemia have serum iron and ferritin level probably lower in comparison with patients without anemia, with erythrocytosis and ACD. In the group of patients with COPD and ACD, low serum levels were detected in comparison with patients without anemia and erythrocytosis, at the same time as with high levels of ferritin, which was significantly higher compared to patients in other groups.

Keywords

• anemia, erythrocytosis, hepcidin, chronic obstructive pulmonary disease