Lupus and your body

What do I need to know about anemia?

Dr. Michael Rosove is a Medical Oncologist in Los Angeles, CA and a Clinical Professor of Medicine at the University of California-Los Angeles, School of Medicine.

See all of Michael Rosove, MD's answers.

The most common blood disorder is anemia, affecting about half of all people with active lupus. Anemia can be measured and discussed in several different ways, including a low red blood cell count, low hemoglobin, or low hematocrit. Each doctor usually has a preference for using a particular term. In the most important sense, anemia means too little hemoglobin. Hemoglobin is the protein inside red cells that carries oxygen from the lungs to all the tissues of the body. Fatigue, a very common lupus symptom, is generally the first and most common symptom of anemia.

Anemia affects about half of all people with active lupus.  Fatigue is usually the first and most common symptom.

Common Causes of Anemia

Normal red blood cells live only 120 days (about four months) and must constantly be produced by the bone marrow. The most common explanation for anemia is reduced red cell production. This may be due to a variety of causes, including:

  • Inflammation
  • Inadequate erythropoietin, a hormone produced by the kidneys, that stimulates the marrow to make more red cells
  • Iron deficiency -- Iron is necessary for the production of hemoglobin.  Iron (as part of the protein hemoglobin) carries oxygen from the lungs throughout the body.  Having too little hemoglobin is called anemia.  Iron deficiency also may result from menstrual bleeding or from intestinal bleeding due to non-steroidal anti-inflammatory drugs. Intestinal bleeding can be obvious if the stool is red, maroon, or black in color, but often bleeding is so slow and gradual that special stool tests are needed to detect it.
  • Loss of bone marrow caused by certain drugs used to treat lupus (such as azathioprine or cyclophosphamide)

The Lupus Foundation of America would like to thank Michael Rosove, MD, for his input.

Medically reviewed on August 08, 2013