Iron deficiency anemia in patients without gastrointestinal symptoms--a prospective study

Niv, Eva; Elis, Avishay; Zissin, Rivka; Naftali, Timna; Novis, Ben; Lishner, Michael

doi:10.1093/fampra/cmh705

Cited by 45 publications

(56 citation statements)

References 15 publications

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“…In contrast, elderly patients in our study revealed a prevalence of malignancies' association with IDA. Indeed, a high rate of colon malignancies, predominantly right-sided colon carcinoma in post-menopausal women and older men with asymptomatic IDA has been reported [21]. Our results also show the benign and malignant colon Cancer can be one of the important etiology of IDA and this is consistent with other studies [22].…”

Section: Discussionsupporting

confidence: 93%

Gastrointestinal Lesions in African American Patients with Iron Deficiency Anemia

Ashktorab¹

2017

Gastrointest Cancer Res Ther

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Background: Iron deficiency anemia (IDA) is a frequent disorder that is associated with many serious diseases. However, the findings of an evaluation of IDA associated gastrointestinal disorders are lacking among African American patients. Aim:To determine the most prevalent gastrointestinal lesions among African American patients with IDA especially in young men. Methods:We reviewed medical records (n=422) of patients referred for evaluation of IDA from 2008 to 2012. IDA was diagnosed using clinical laboratory tests. The results of esophagogastroduodenoscopy (EGD), colonoscopy and pathology specimens along with demographic data were abstracted and analyzed using STATA. Results:The mean age was 61.9 years, and 50.5% were female. 189 patients (45%) had gross GI bleeding. The most frequent diagnoses were gastritis (40%), benign colonic lesions (13%), esophagitis (9%), gastric ulcer (6%), and duodenitis (6%). By sex, duodenal benign tumors were significantly more represented among females: 4% vs 1% (p=0.05) while left colon malignancy was more prevalent among males: 3% vs 0.05% (p=0.05). Benign and malignant colonic lesions were significantly more present among older patients: 16% vs 6% (P=0.005) and 5% vs 0% (p=0.008), respectively. Colitis was more prevalent in younger patients (≤50): 11% vs 2% (p=0.001). In patients with gross lower GI bleeding, the top diagnoses were gastritis (25%), benign colon tumors (10%), and duodenitis (6%). Colon cancer was diagnosed among 15 patients and all these patients were older than 50 years of age. Conclusion:This exploratory analysis of IDA associated GI lesions revealed that gastritis and colonic lesions are most common lesions found among African Americans with IDA with minimal age and sex differences. Colitis was found more in young patients while IDA was more associated with lower GI malignancies in older patients. Upper GI endoscopy might be required if colonoscopy is unrevealing of the cause of IDA.

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Section: Discussionsupporting

confidence: 93%

Gastrointestinal Lesions in African American Patients with Iron Deficiency Anemia

Ashktorab¹

2017

Gastrointest Cancer Res Ther

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“…The levels of transferrin have been shown to increase in iron deficiency anemia [5,6]. Additionally, incidents of bleeding in cancer patients can result in iron deficiency anemia, which subsequently increases the levels of lactoferrin [7–9]. Furthermore, patients with iron deficiency anemia are about four times more susceptible to contracting pneumonia than non-anemic individuals.…”

Section: Introductionmentioning

confidence: 99%

Induction of the pneumococcal vncRS operon by lactoferrin is essential for pneumonia

et al. 2018

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Streptococcus pneumoniae (pneumococcus), the major pathogen for pneumonia, commonly colonizes the lung, but the mechanism underlying the coordination of virulence factors during invasion via the host protein remains poorly understood. Bacterial lysis releases the components of the cell wall, and triggers innate immunity and the subsequent secretion of pro-inflammatory cytokines. Previously, the virulence of the pep27 mutant was shown to be attenuated as a feasible candidate for vaccine development. However, the role of pep27 gene, belonging to the vancomycin-resistance locus (vncRS operon), in virulence, is largely unknown. This study demonstrates that transferrin in the host serum reduces the survival of the host during S. pneumoniae infections in mice. The exposure of the pneumococcal D39 strain to lactoferrin induced the vncRS operon, lysis, and subsequent in vivo cytokine production, resulting in lung inflammation. However, these responses were significantly attenuated in pneumococci harboring a mutation in pep27. Mechanistically, the VncS ligand, identified as lactoferrin, induced the vncRS operon and increased the in vivo mortality rates. Thus, serum-induced activation of vncRS plays an essential role in inducing pneumonia.

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“…Although iron-deficiency anemia is a very common clinical problem, most studies have examined small, heterogenous cohorts of patients with varying demographic and anemia parameters (10). The present study focused on men !18 years old to investigate the various causes of irondeficiency anemia in a prospective fashion.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Evaluation of Adult Men with Iron-deficiency Anemia in Korea

et al. 2011

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Objective Iron-deficiency anemia (IDA) is the most common nutritional deficiency worldwide. However, the information concerning various causes of IDA in adult men is still insufficient. The aim of our study was to evaluate adult men with IDA. Methods We prospectively studied 206 adult men with IDA. All subjects had a direct history taken and underwent a physical examination. Esophagogastroduodenoscopy was performed in most patients, and colonoscopy was conducted if no lesion causing IDA was found or the fecal occult blood test was positive. Results The history of prior gastrectomy and blood-letting cupping therapy that probably had caused IDA were reported in 24 (11.7%) and 11 (5.3%) patients, respectively. In terms of potential causes of IDA, 68 (33.0%) patients were found to have upper gastrointestinal disorders (34 peptic ulcers, 17 erosive gastritis, 16 gastric cancers, and one gastrointestinal stromal tumor). Colonoscopy showed 42 (20.4%) clinically relevant lesions that probably caused IDA: colon cancer (five patients), colon polyps (14 patients), ulcerative colitis (one patient), and hemorrhoids (22 patients). One small bowel tumor was detected at small bowel series. Concerning malignant lesions that were responsible for IDA, 22 malignant lesions were found in patients of 50 years or older, accounting for 16.8% (22 of 131 patients), while only one (1.3%) early gastric cancer was found in the younger patients. Conclusion This study demonstrated that gastrointestinal blood loss is the main cause of IDA in adult men, and that there is a high rate of malignancy in men older than 50 years, emphasizing the need for a complete, rigorous gastrointestinal examination in this group of patients. Considering blood-letting cupping therapy, there is a need to consider culture-specific procedures as a possible cause of IDA.

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Iron deficiency anemia in patients without gastrointestinal symptoms--a prospective study

Cited by 45 publications

References 15 publications

Gastrointestinal Lesions in African American Patients with Iron Deficiency Anemia

Gastrointestinal Lesions in African American Patients with Iron Deficiency Anemia

Induction of the pneumococcal vncRS operon by lactoferrin is essential for pneumonia

A Prospective Evaluation of Adult Men with Iron-deficiency Anemia in Korea

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