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Anaemia of Chronic Disease: The anaemia of chronic disease in the context of rheumatoid arthritis has been found to be related to TNF and can be reversed by administration of infliximab, a specific monoclonal antibody directed against TNF. In rheumatoid arthritis there is depletion of early erythroid progenitor cells, increased apoptotic cell death among the progenitors and early erythroid precursors, consequent reduction in mature erythroid presursors and development of anaemia. The presence of reticuloendothelial iron in this anaemia of chronic disease appears to represent 'iron-banking' rather than iron-trapping or blockade and would be due to reduced erythroid iron demand after precursor depletion and/or increased erythroid iron-return to the reticuloendothelial stores as a result of erythroid apoptosis. Read more: Lancet 2002;360:1713-14 Blood 2002;99:1610-19 Blood 2002; 100:474-82 |