Anemia and Iron Deficiency in Inflammatory Bowel Disease Patients in a Referral Center in Brazil: Prevalence and Risk Factors

Parra, Rogério Serafim; Feitosa, Marley Ribeiro; Ferreira, S. E. S.; Rocha, José Joaquim Ribeiro da; Troncon, Luiz Ernesto de Almeida; Féres, Omar

doi:10.1590/s0004-2803.202000000-51

Cited by 12 publications

(5 citation statements)

References 36 publications

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“…Analyzing the association between gender and prevalence of anemia in IBD patients, several authors reported that females had a significantly higher prevalence of anemia compared to males, suggesting the blood loss during menstruation as an additional aggravating factor [21][22][23][24]. Contrary to these findings, other authors did not find a significant difference in the prevalence of anemia in boys and girls with IBD [16].…”

Section: Discussionmentioning

confidence: 90%

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Anemia in Newly Diagnosed Pediatric Patients with Inflammatory Bowel Disease

Shentova

Kofinova

Hadzhiyski

et al. 2021

Gastroenterology Insights

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Anemia is the most common extraintestinal manifestation and complication of inflammatory bowel disease (IBD). The aim of our study was to assess the prevalence of anemia in newly diagnosed pediatric patients with IBD and to analyze its association with disease type, extent, and severity. We retrospectively reviewed the medical records of all patients with IBD treated in our department in the period of November 2011 to November 2020. The final analysis included the records of 80 children with newly diagnosed IBD: 45 with ulcerative colitis (UC) and 35 with Crohn’s disease (CD). The prevalence of anemia was 60.0% in the UC patients and 77.1% in the CD patients. Of the UC patients with anemia, 37.1% had pancolitis, 18.5% extensive disease, 33.3% left-sided colitis and 11.1% ulcerative proctitis. Of the CD patients with anemia, 81.5% had ileocolonic disease, 11.1% colonic disease and 7.4% ileal disease. Anemia was less common in patients with mild disease than in patients with moderate–severe disease (22.2 vs. 77.8%, p < 0.001 in UC and 25.9% vs. 74.1%, p < 0.001 in CD). Our study confirmed anemia as a frequent problem in pediatric patients with IBD. Children with more extensive and more severe disease are at higher risk to develop anemia.

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Section: Discussionmentioning

confidence: 90%

“…In a recent study, Parra et al [24] found no association between anemia and disease location in adult patients with IBD (CD and UC). In contrast, Sjoberg et al [19] reported extensive disease in UC and colonic CD at diagnosis as additional risk factors for anemia in pediatric patients with IBD.…”

Section: Discussionmentioning

confidence: 91%

Anemia in Newly Diagnosed Pediatric Patients with Inflammatory Bowel Disease

Shentova

Kofinova

Hadzhiyski

et al. 2021

Gastroenterology Insights

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“…Furthermore, one recently published study showed that anemia in 6.5% of patients preceded the diagnosis of IBD by over a year [ 20 ]. On the other hand, Parra et al showed that only 35.5% of 529 patients with anaemia in the course of IBD had a full laboratory analysis, including the assessment of iron metabolism [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Laboratory Characteristics of Anaemia in Hospitalized Patients with Inflammatory Bowel Disease

Woźniak

Borkowska

Jastrzębska³

et al. 2023

JCM

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Anaemia is the most common extraintestinal manifestation of inflammatory bowel disease (IBD). Due to its multifactorial etiopathogenesis, the differential diagnosis and treatment of anaemia in IBD is a significant clinical problem. The main aim of our study was to assess the usefulness of laboratory parameters, including hepcidin, in differential diagnoses of anaemia in hospitalized IBD patients. This study also estimated the impact of anaemia on the length of hospitalization and its relationship with clinical data of analyzed patients. The study included 118 adult patients diagnosed with IBD—55 with ulcerative colitis (UC) and 63 with Crohn’s disease (CD). Anaemia was significantly more frequent in patients with CD—42 (66.7%)—compared to 31 (56.4%) patients with UC (p = 0.033). The prevalence of anaemia increased significantly with the severity of IBD and the extent of inflammatory changes in the endoscopic examination. Hospitalization time was significantly longer in patients with anaemia, especially in the group with UC. Ferritin concentrations < 30 ng/mL were found only in 15 (20.55%) IBD patients (9 with UC and 6 with CD), and ferritin < 100 ng/mL was observed in 22 (30.14%) patients, equally frequent with UC and CD (p > 0.05). Significantly higher concentrations of transferrin were observed in patients with anaemia in the course of UC compared to CD (2.58 ± 0.90 g/L vs. 2.15 ± 0.82 g/L; p = 0.037). On the other hand, saturation of transferrin < 16% was equally common in UC and CD patients. In our study, hepcidin levels in anaemic UC patients were significantly lower compared to UC without anaemia (p = 0.042), with no similar differences in CD independently of anaemia presence (p = 0.565). To conclude, we observed a high incidence of anaemia in patients with IBD and its significant impact on the length of hospitalization in UC. Routinely determined single laboratory parameters are not sufficient for the differential diagnosis of anaemia, and a complex laboratory assessment, including of hepcidin levels, is necessary for the full picture of anaemia in the course of IBD.

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“…Iron deficiency is a common condition in patients with inflammatory diseases [ 1 ]. Specifically, up to three quarters of patients with chronic inflammatory bowel disease (IBD) experience iron deficiency, resulting in frequent IBD extra-intestinal manifestations [ 2 , 3 ]. Iron deficiency has a multifactorial origin as it depends on blood loss, a reduced intake, or a reduced absorption of iron [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Iron Deficiency in Patients with Inflammatory Bowel Diseases: A Prospective Multicenter Cross-Sectional Study

et al. 2022

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Background Iron deficiency (ID) is a frequent condition in patients with inflammatory bowel disease (IBD). Aim Our aim was to investigate the prevalence of ID in patients with IBD. Methods This was a prospective multicenter cross-sectional study conducted in 21 gastroenterology departments in France between January and March 2020. All adult patients with confirmed IBD who were admitted to the hospital were eligible for inclusion. ID was defined as ferritinemia ≤ 100 μg/L in patients with signs of inflammation (C-reactive protein (CRP) ≥ 5 mg/L) or ferritinemia < 30 μg/L in the absence of inflammation. Results In total, 1036 IBD (685 Crohn's disease and 351 ulcerative colitis) patients (52.1% women) with a mean age of 41.8 ± 15.5 years were recruited. Approximately half of the patients (504, 51.1%) were in disease remission at the time of enrollment. Systematic monitoring of iron status was performed in 12/21 (57%) participating centers, including measurements of ferritin (12/12, 100%), hemoglobin (11/12, 92%), transferrin saturation (TSAT) (6/12, 50.0%), and serum iron (5/12, 42%). About one-fifth of the patients had been treated with intravenous iron (218, 21.0%), whereas only a small percentage received oral iron (36, 3.5%). ID occurred in 97 patients (23.7% CI 95% 19.8-28.1). Patients with moderate/severe IBD activity (OR: 3.66; CI 95% 24.4-61.2; p = 0.007) or concomitant anemia (OR: 3.66; CI 95% 1.97-6.78; p < 0.001) had an increased likelihood of having ID. Conclusion Patients with moderate/severe IBD activity or concomitant anemia are at increased risk of ID. Early detection and management of ID in patients with IBD is recommended.

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Anemia and Iron Deficiency in Inflammatory Bowel Disease Patients in a Referral Center in Brazil: Prevalence and Risk Factors

Cited by 12 publications

References 36 publications

Anemia in Newly Diagnosed Pediatric Patients with Inflammatory Bowel Disease

Anemia in Newly Diagnosed Pediatric Patients with Inflammatory Bowel Disease

Clinical and Laboratory Characteristics of Anaemia in Hospitalized Patients with Inflammatory Bowel Disease

Iron Deficiency in Patients with Inflammatory Bowel Diseases: A Prospective Multicenter Cross-Sectional Study

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