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(Chest. 2005;127:825-829.)
© 2005 American College of Chest Physicians

Anemia and Inflammation in COPD*

Matthias John, MD, PhD; Soeren Hoernig, MD; Wolfram Doehner, MD; Darlington D. Okonko, MD; Christian Witt, MD, PhD and Stefan D. Anker, MD, PhD

* From the Department of Pneumology (Campus Mitte) [Drs. John, Witt, and Hoernig] and Applied Cachexia Research, Cardiology (Campus Virchow-Klinikum) [Dr. Doehner], University Hospital Charité, Berlin, Germany; and Department of Clinical Cardiology (Drs. Okonko and Anker), National Heart & Lung Institute, Imperial College, London, UK.

Correspondence to: Matthias John, MD, PhD, Department of Pneumology, University Hospital Charité, Campus Mitte, Schumannstr. 20/21, 10098 Berlin, Germany; e-mail: matthias.john{at}charite.de

Background: Anemia in patients with COPD and its pathophysiology is an understudied issue.

Methods: In a group of 101 COPD patients (FEV1 percentage of predicted, 37 ± 2% [mean ± SEM]; mean age, 61 ± 1 years; 35% female gender), the prevalence of anemia and its relationship to body mass and weight loss, inflammatory parameters, and erythropoietin levels was determined. Data were compared to a control group (healthy persons with matched age) in order to identify potential factors that may influence the development of anemia in patients with COPD.

Results: Anemia was diagnosed in 13 patients (hemoglobin levels < 13.5 mg/dL in male patients and < 12.0 mg/dL in female patients), which represents a prevalence of 13%. Anemic COPD patients showed elevated erythropoietin levels (41.8 ± 25.4 U/L vs 16.3 ± 2.9 U/L) and an increased inflammatory response compared to nonanemic patients. A significant inverse correlation of hemoglobin vs erythropoietin (r = – 0.84, p < 0.01) was observed in anemic COPD patients, but not in the nonanemic group.

Conclusion: Anemic COPD patients show high erythropoietin levels, which may indicate presence of erythropoietin resistance. The latter may be mediated through inflammatory mechanisms, which is typical for anemia of chronic illness.

Key Words: anemia • COPD • inflammation




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L. Mascitelli, F. Pezzetta, and M. John
Anemia and COPD
Chest, October 1, 2005; 128(4): 3084 - 3084.
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