Anemia of inflammation (AI), a normochromic, normocytic anemia, associated with abnormal iron utilization, erythropoietin hyporesponsiveness, and decreased red blood cells (RBC) survival is a very common problem in hospitalized patients for acute inflammatory diseases and develops within few days from the onset of illness. Deleterious effects of anemia include increased risk of cardiac related morbidity and mortality in critically ill and older patients.

Anemia is mediated by hepcidin, the 25-amino acid polypeptide hormone that is central to iron trafficking.

Several studies have been performed on pathophysiology of AI in patients affected by chronic diseases but few explore iron metabolism in humans with acute inflammation.

The aim is to develop effective new strategies to detect and manage AI in the setting of acutely ill patients, based on the understanding of iron balance underlying this disorder.

Inclusion Criteria (both):

• serum C-reactive protein level > 3mg/dL
• creatinine level < 2mg/dL (clearance > 30%)

Exclusion Criteria:

• any haematological diseases
• cancer under chemotherapy
• AIDS (or HIV+)
• liver cirrhosis
• genetic hemochromatosis
• immunosuppressive therapy
• blood transfusion in the past 30-days

all consecutive patients admitted to Internal Medicine ward because of acute inflammatory illness