About half of the patients with active lupus are anemic. The severity of the anemia is usually proportional to the activity level of a person's lupus. Fatigue, suffered by many patients with active lupus, can be attributed in part, to anemia. Anemia is not a specific condition, but has many causes. In a person with lupus, anemia may be caused by chronic inflammation, prolonged uremia, iron deficiency, or hemolytic anemia.
Inflammation is an important cause of anemia in lupus patients.
Prolonged inflammation hinders the production of red blood cells by the bone marrow, the tissue hidden within bones that produces blood cells. Therefore, treatment with iron is useless in anemia due to inflammation. Only alleviation of the inflammatory condition restores normal red blood cell production. Prolonged uremia due to impaired kidney function, may also cause anemia in persons with lupus. Occasionally, severe forms of anemia induced by chronic uremia require blood transfusions.