Protocolo diagnóstico y terapéutico de la anemia en pacientes con artritis reumatoide

Anemia is one of the most frequent extra-articular manifestations and the most common hematologic disorder in patients with rheumatoid arthritis. The most frequent are anemia of chronic disease (ACD), which is usually mild normocytic normochromic and asymptomatic, and iron-deficiency anemia. Macrocytic, hemolytic, and drug-induced anemia occur less frequently. Its prevalence in rheumatoid arthritis ranges from 30% to 70%, depending on the series studied. ACD is due to a combination of reduced iron availability in peripheral blood and decreased erythroid formation in the bone marrow. It is fundamental to identify the cause in order to establish treatment, as anemia in rheumatoid arthritis is often assumed to be due to chronic disorders and is sometimes inadequately treated by intensifying treatment with disease-modifying drugs.