Revista Portuguesa de Pneumologia Revista Portuguesa de Pneumologia
Rev Port Pneumol 2017;23:146-55 - Vol. 23 Num.3 DOI: 10.1016/j.rppnen.2016.12.005
Review
The impact of anaemia and iron deficiency in chronic obstructive pulmonary disease: A clinical overview
A. Robalo Nunesa,, , M. Tátáb
a Serviço de Imunohemoterapia/Medicina Transfusional, Hospital das Forças Armadas (Pólo de Lisboa), Lisboa, Portugal
b Serviço de Pneumologia, Hospital das Forças Armadas (Pólo de Lisboa), Lisboa, Portugal
Received 27 July 2016, Accepted 12 December 2016
Abstract
Introduction

Anaemia is increasingly recognised as an important comorbidity in the context of chronic obstructive pulmonary disease (COPD), but remains undervalued in clinical practice. This review aims to characterise the impact of anaemia and iron deficiency in COPD.

Methods

Literature review of studies exploring the relationship between anaemia/iron deficiency and COPD, based on targeted MEDLINE and Google Scholar queries.

Results

The reported prevalence of anaemia in COPD patients, ranging from 4.9% to 38.0%, has been highly variable, due to different characteristics of study populations and lack of a consensus on the definition of anaemia. Inflammatory processes seem to play an important role in the development of anaemia, but other causes (including nutritional deficiencies) should not be excluded from consideration. Anaemia in COPD has been associated with increased morbidity, mortality, and overall reduced quality of life. The impact of iron deficiency, irrespective of anaemia, is not as well studied, but it might have important implications, since it impacts production of red blood cells and respiratory enzymes. Treatment of anaemia/iron deficiency in COPD remains poorly studied, but it appears reasonable to assume that COPD patients should at least receive the same type of treatment as other patients.

Conclusions

Anaemia and iron deficiency continue to be undervalued in most COPD clinical settings, despite affecting up to one-third of patients and having negative impact on prognosis. Special efforts should be made to improve clinical management of anaemia and iron deficiency in COPD patients as a means of achieving better patient care.

Keywords
Chronic obstructive pulmonary disease, COPD, Anaemia, Iron deficiency, Iron deficiency anaemia, Inflammation
Rev Port Pneumol 2017;23:146-55 - Vol. 23 Num.3 DOI: 10.1016/j.rppnen.2016.12.005