Anemic syndrome in patients with community-acquired pneumonia

Abstract

Community-acquired pneumonia remains a most widespread acute infectious disease of socio-economic significance all over the world. Up to 30% of the patients present with anemia responsible for the unfavourable prognosis and elevated mortality. Not infrequently, anemia is not diagnosed during the hospital stay und therefore remains uncorrected. Severe anemia results in enhanced hypercapnia and slowed maturation of red blood cells in the bone marrow which facilitates the development of ischemic syndrome. Hepcidin, a mediator of inflammation and iron-regulatory hormone, plays an important role in the clinical course of community-acquired pneumonia. Hepsidin production increases during inflammation; it suppresses erythtropoiesis and depletes the iron depot leading to so-called anemia of inflammation. Hypoxia and anemia activate erythtropoiesis, and the released erythropoietin inhibits hepsidin production. During pneumonia resolution, hepsidin promotes recovery from anemia by activating iron absorption. The current literature contains few data on the use of hepcidin as a diagnostic marker of anemia. The necessity of treating anemia in patients with pneumonia under hospital conditions is a matter of discussion. Direct involvement of hepcidin in iron metabolism creates a prerequisite for the treatment of anemia. Medicamental suppression of its activity by stimulating erythtropoiesis can facilitate normalization of iron metabolism and restoration of hemoglobin level.

Comparison of the Acute Erythropoietic Capacities of Erythropoietin and U-74389G Concerning Red Blood Cells Counts

“…[24] caused hypoxia which increased Epo expression higher than 70% being responsible for regulating the RBC growth and development in C2C12 myoblasts, myotubes, and primary myoblasts in vitro than unexercised controls [25]. Found a dose-dependent increase in RBC count in rHuEPO200, rHuEPO400 and rHuEPO600 therapy groups whereas increase in reticulocyte count only in rHuEPO400 and rHuEPO600 therapy groups in male Wistar rats [26]. induced slowed maturation of RBC in the bone marrow inhibiting hepsidin production, after Epo release and erythropoiesis activation.…”

Faktor-Faktor yang Berhubungan dengan Length of Stay Pasien Pneumonia di Rumah Sakit Umum Haji Medan

“…Kondisi anemia pada pasien disebabkan oleh tubuh yang mengalami peningkatan hormon hepsidin dan feritin yang muncul sebagai penanda etiologi mikroba pneumonia CAP (Oppen et al, 2021). Produksi hepsidin menyebabkan terjadinya peningkatan proses pembentukan eritrosit sehingga mengurangi penyimpanan zat besi di sumsum tulang dan menghambat pematangan sel darah merah yang memfasilitasi perkembangan sindrom iskemia atau kekurangan pemasokan aliran darah hingga terjadilah anemia yang menyebabkan prognosis buruk dan risiko kematian (Budnevsky et al, 2016).…”

Association between Anemia and Severe Pneumonia among Children 6-59 Months Old in RSUD Wangaya, Denpasar: A Cross Sectional Study

“…In turn, pneumonia leads to inflammatory anemia by increasing serum hispinin which suppresses erythropoiesis. 13 Anemia may associated with pneumonia as it worsen pneumonia through the hypercapnia mechanism and also slow down the redcell maturation in bone marrow, therefore the hypoxic mechanism will eventually worsen pneumonia. In the other hand, pneumonia could cause or worsen anemia through the increased level of hepcidin that supressed erythropoiesis and will cause inflammatory anemia.…”