A Prospective, Multidisciplinary Evaluation of Premenopausal Women With Iron-Deficiency Anemia

Kepczyk, Thomas; Cremins, JE; Long, B. D.; Bachinski, M.; Smith, Lord; McNally, Peter R.

doi:10.1111/j.1572-0241.1999.00780.x

Cited by 47 publications

(46 citation statements)

References 17 publications

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“…One of twelve patients who underwent colonoscopy had pancolitis; the remaining 11 patients had lower gastrointestinal findings that were not responsible for IDA. The investigators of this study concluded that upper endoscopy should be considered in the evaluation of all premenopausal women with IDA who have digestive complaints or who have anemia that is refractory to iron supplementation [6].…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of Premenopausal Women with Anemia: What Is the Yield of Gastrointestinal Endoscopy?

2008

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Anemia is not uncommon in premenopausal women. The purpose of this study was to determine the yield of endoscopy in premenopausal women with anemia. We identified and reviewed the medical records of 168 premenopausal women who underwent upper endoscopy and/or colonoscopy for the indication of iron deficiency anemia (IDA) during the years 1996 through 2005. Of the 168 patients, 100 (59.5%) underwent upper endoscopy and 155 (92.3%) underwent colonoscopy. Eighty-seven (51.8%) patients underwent both procedures. The mean age was 43.1 +/- 5.8 years. The mean hemoglobin was 10.2 +/- 1.3 g/dl. Upper gastrointestinal (GI) lesions potentially causative for anemia were found in 7 of 100 patients who underwent upper endoscopy (7%). Significant lower GI lesions were found in 6 of 155 (3.9%) of those who had a colonoscopy. Our data suggest that both upper endoscopy and colonoscopy were useful in the detection of significant gastrointestinal lesions in premenopausal women with anemia.

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Section: Discussionmentioning

confidence: 99%

The Evaluation of Premenopausal Women with Anemia: What Is the Yield of Gastrointestinal Endoscopy?

2008

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“…However, even in young women with iron deficiency intervention, then further evaluation may be warranted before a lengthy wait for a hematologic response. Postfelt secondary to menstrual bleeding, occult gastrointestinal bleeding and hemorrhagic gastrointestinal pathology treatment observation is also confounded by the blackening of stools from the administration of medicinal can be demonstrated in a substantial proportion and should be looked for [23]. Finally, it might be argued iron and the inability to discern melena from bleeding.…”

Section: Impact Of Fob Testing On Diagnostic Algorithmsmentioning

confidence: 99%

“…Menstrual bleeding is by far the most common explanation for excessive nongastrointestinal blood loss and acIron deficiency results from inadequate procurement of iron (due either to an iron-poor diet or to iron malab-counts for the majority of iron deficiency among premenopausal women [12,16,23]. Blood loss leading sorption) or from excessive loss of iron through bleeding.…”

Section: To What Extent Does Occult Gastrointestinal Bleeding Cause Imentioning

confidence: 99%

“…At nearly all ages, peptic ulcer disease remains the most frequent gastrointestinal finding among iron-deficient patients [12,16]. In general, the proportion of iron deficiency due to inflammatory and infectious gastrointestinal lesions is higher in children and younger adults, as the proportion due to neoplasms and vascular anomalies increases in the more elderly [12,16,[21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Importantly, most culpable lesions in iron-deficient patients are located in the upper gastrointestinal tract (table 2).…”

Section: To What Extent Does Occult Gastrointestinal Bleeding Cause Imentioning

confidence: 99%

“…iron deficiency varies by age and gender (table 1). Occult gastrointestinal bleeding is the major cause of iron deficiency in adult males and postmenopausal women, but Occult Gastrointestinal Bleeding An impressive volume of blood may be lost into the it must be considered as a potential mechanism for iron deficiency in all age groups [12,16,[21][22][23][24][25][26][27][28][29][30][31][32][33][34]. The mecha-gastrointestinal lumen and yet remain occult.…”

Section: To What Extent Does Occult Gastrointestinal Bleeding Cause Imentioning

confidence: 99%

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Fecal Occult Blood Testing for Iron Deficiency: A Reappraisal

Harewood¹,

Ahlquist²

2000

Dig Dis

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Fecal occult blood (FOB) tests have been evaluated primarily for the application of colorectal cancer screening. Less is known about the performance characteristics of FOB tests for the evaluation of iron deficiency, the most common other application. As most clinically important occult gastrointestinal bleeding arises from the proximal gut, it is critical that FOB tests target analytes that are stable during the enteric transit. Available data indicate that guaiac-type and immunochemical tests are insensitive for the detection of proximal gut bleeding, and their use may confound the evaluation of iron deficiency. In contrast, the heme porphyrin test is sensitive for both proximal and distal sources of occult gastrointestinal bleeding, and this FOB test would appear to be the most rational selection for use in patients with iron deficiency or anemia. Outcome data are needed to better assess the impact of FOB testing on algorithms for evaluation of iron deficiency.

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Menstruation does not cause anemia: Endometrial thickness correlates positively with erythrocyte count and hemoglobin concentration in premenopausal women

Clancy

Nenko

Jasieńska

2006

American J Hum Biol

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Menstruation has often been cited as a risk factor for iron-deficiency anemia. This study tested whether normal, premenopausal women's luteal endometrial thickness (ET) was associated with their red blood cell count (RBC) and hemoglobin concentrations (Hg), and therefore whether a high ET put women at risk for anemia. Endometrial thickness can be considered a reasonable proxy for menstrual blood loss in normal women. Twenty-six healthy women from the Mogielica Human Ecology Study Site in Poland, aged 20-40 years (29 +/- 5.3 years, mean +/- SD), were selected. Subjects' ET was measured by transvaginal ultrasound in the luteal phase of the menstrual cycle, and their red blood cell count and hemoglobin concentrations were measured by fasting morning blood samples. Controlling for day of ET measurement, RBC and Hg were positively correlated with ET (r(2) = 0.24, P = 0.05; r(2) = 0.25, P = 0.04, respectively). We propose that, contrary to popular understanding, a thicker endometrium suggests greater iron reserves, rather than greater risk for anemia, in healthy women.

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A Prospective, Multidisciplinary Evaluation of Premenopausal Women With Iron-Deficiency Anemia

Cited by 47 publications

References 17 publications

The Evaluation of Premenopausal Women with Anemia: What Is the Yield of Gastrointestinal Endoscopy?

The Evaluation of Premenopausal Women with Anemia: What Is the Yield of Gastrointestinal Endoscopy?

Fecal Occult Blood Testing for Iron Deficiency: A Reappraisal

Menstruation does not cause anemia: Endometrial thickness correlates positively with erythrocyte count and hemoglobin concentration in premenopausal women

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