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- Title
Unexplained anemia in elderly: An emerging problem.
- Authors
Gupta, Shrinza; Kotru, Mrinalini; Goel, Ashish
- Abstract
Introduction: The population of elderly is increasing all over the world. Anemia is a common problem in elderly. Approximately one-third of anemia cases are attributed to "unexplained anemia", for which no cause could be found. Unexplained anemia is typically mild, hence likely to be overlooked. It is associated with significant morbidity and mortality. Exact pathogenesis is poorly characterized despite various studies. The proper understanding would lead to better management and quality of life. Materials and Methods: The search was conducted in August 2018. After extensive search on PubMed & Google Scholar, using keywords Unexplained Anemia; Aging; Hematopoietic stem cells; Anemia in the elderly, a total of 538 results were identified. After applying filters like Review, Full text, Humans, 65+ years, 28 results were identified. Out of these, 16 were selected and 12 were not relevant to our search as they didn't talk about the possible pathogenesis of unexplained anemia. Observations: Age associated renal insufficiency resulting in reduced erythropoietin response. Hematopoietic stem cells undergo qualitative changes with age with resultant decrease in erythropoietic reserve. Age associated reduction in androgen levels in both males and females, to some extent contribute to a decline in erythroid reserve. Age associated increased pro-inflammatory mediators mainly IL-6, which may inhibit hematopoiesis by inhibition of erythropoietin. Analysis of erythroid compartment in myelodysplastic syndrome revealed increased percentage of immature erythroid precursors. Conclusion: Unexplained anemia is a complex entity in view that it is multifactorial. We suggest the above age-associated factors that contribute to majority of unexplained anemia cases in elderly.
- Subjects
HEMATOPOIETIC stem cells; ANEMIA; COMPARTMENT syndrome; MYELODYSPLASTIC syndromes; KIDNEY failure
- Publication
Journal of the Indian Academy of Geriatrics, 2018, Vol 14, p181
- ISSN
0974-3405
- Publication type
Article