Anemia in the Patient with Chronic Lung Disease

  • Tim J. McMahonEmail author
  • Ann C. Prybylowski


Chronic lung disease is sometimes associated with erythrocytosis, especially when chronic hypoxemia is present. Anemia, even in the presence of hypoxemia, is also relatively common in chronic lung diseases, such as chronic obstructive pulmonary disease (COPD). Recognizing anemia in these patients is essential as anemia may exacerbate symptoms of dyspnea, limit patients’ functioning, raise health care costs, and worsen overall prognosis. The most common type of anemia in chronic lung disease is anemia of chronic disease (ACD). Identifying other types or causes of anemia in the patient with chronic lung disease is critical because treatment of the underlying lung disease remains unsatisfactory in lung diseases like emphysema, chronic bronchitis, idiopathic pulmonary fibrosis, and cystic fibrosis. After describing some of the unique factors driving ACD as well as other causes of anemia in patients with chronic lung disease, we will review the available evidence on which to base decisions concerning anemia management in this population.


Anemia Anemia of chronic disease Asthma Chronic obstructive pulmonary disease (COPD) Cystic fibrosis Emphysema Hypoxemia Iron-deficiency anemia Pulmonary fibrosis Pulmonary arterial hypertension 



The authors thank Dan Gilstrap, MD for an expert literature search that aided in constructing this chapter, and Amy Loeblein for expert editorial work. Research funds from VA (I01-BX-003478 to TJM) and NIH (GM-113838 to TJM) helped support this work.


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© Springer Science+Business Media LLC 2018

Authors and Affiliations

  1. 1.Department of MedicineDuke University and Durham VA Medical CentersDurhamUSA
  2. 2.Duke University and University of Pennsylvania Medical CentersPhiladelphiaUSA

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