Slow Hematological Recovery in Children With IBD‐associated Anemia in Cases of “Expectant Management”

Pels, Lise P. M.; Vijver, Els Van de; Waalkens, Herman J.; Uitentuis, Jan; Jong, Gieneke Gonera-de; Overbeek, Lidy A. T. van; Norbruis, Obbe F.; Rings, Edmond H. H. M.; Rheenen, Patrick F. van

doi:10.1097/mpg.0b013e3181da4d8b

Cited by 22 publications

(21 citation statements)

References 27 publications

(33 reference statements)

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“…Although anemia and iron deficiency are highly prevalent in pediatric patients with IBD, focus of treatment lies often only on intestinal inflammation, which results in a slow hematological recovery [ 18 ]. Further to anemia management, the administration of iron also appeared to result in decreases respectively normalization of white cell count, platelets and C-reactive protein.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of ferric carboxymaltose treatment in children and adolescents with inflammatory bowel disease and other gastrointestinal diseases

et al. 2014

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BackgroundThe treatment of iron deficiency anemia in children with inflammatory bowel disease is a particular challenge and often insufficient. Absorption of orally given iron may be impaired by intestinal inflammation and treatment with oral iron may aggravate intestinal inflammation. This retrospective study is the first to describe the use of intravenous ferric carboxymaltose (FCM) in the pediatric setting.MethodsAll subjects who had received at least one dose of FCM intravenously in the observation period were included in this analysis with data collected for up to 3 months post last FCM dose.ResultsIn total, 72 children between 0 and 18 years with underlying gastrointestinal disorders had been treated for concomitant iron deficiency anemia. The majority of patients had Crohn’s disease (40.3%) or ulcerative colitis (30.5%). The total number of FCM administrations was 147, the mean number per patient was 2.0 and the mean cumulative dose 821 mg iron (median single dose: 500 mg; max. 1000 mg). Post administration of FCM, correction of iron deficiency anemia was observed with improved mean hemoglobin levels from 9.5 g/dL at baseline to 11.9 g/dL within 5–12 weeks. Decreases in white cell count, platelets and C-reactive protein were observed post FCM, potentially suggesting reduced inflammation with iron repletion. Three subjects reported mild adverse drug reactions related to FCM; two of these were considered to be potentially related to long duration of administration and to high volume of saline solution for dilution. As such, the method of administration was amended to have a maximum infusion time of 60 minutes and dilution with less than or equal to 100 mL saline solution.ConclusionsOverall FCM was well tolerated in this pediatric population and appeared to be effective in correcting iron deficiency anemia. We cannot exclude that the correction of iron deficiency anaemia is in some part due to the treatment of the underlying disease and not related to the iron supplementation only.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-230X-14-184) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of ferric carboxymaltose treatment in children and adolescents with inflammatory bowel disease and other gastrointestinal diseases

et al. 2014

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“…Iron ID, IDA, and anemia of chronic disease (ACD), recently defined by ECCO guidelines are common in pediatric IBD (81)(82)(83). Expectant management of IBD-associated anemia is associated with persistence of the anemia, well beyond induction of remission, in up to 50% of patients (84,85). The impact of ACD/IDA, which may co-exist, and even ID on the quality of life (QoL) of IBD patients, is considerable (83,86,87).…”

Section: Seleniummentioning

confidence: 99%

Nutrition in Pediatric Inflammatory Bowel Disease

Miele

Shamir

Aloi

et al. 2018

J. pediatr. gastroenterol. nutr.

133

113

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“…When and How to Monitor Patients for ID and Anemia ID and anemia monitoring in pediatric IBD patients should be included in the laboratory assessment plan according to disease activity [3, 5,39]. Iron status should be measured every 3 months during the first year after anemia correction, and every 6 months thereafter [67,69,70]. If an adequate Hb level is not reached after IV iron administration and/or inadequate iron stores persist, monitoring should be performed early and according to patient needs [67,69].…”

Section: Monitoring and Prevention Of Id And Ida Recurrencementioning

confidence: 99%

Portuguese Consensus on Diagnosis, Treatment, and Management of Anemia in Pediatric Inflammatory Bowel Disease

Lopes

Azevedo

Cabral

et al. 2020

GE Port J Gastroenterol

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Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD), both in pediatric and in adult patients. Iron deficiency is the main cause of anemia in patients with IBD. Anemia is a clinically relevant comorbidity, with impact on patients' quality of life and it should be timely diagnosed and adequately treated. Currently, an active treatment approach is the recommended strategy, with evidence showing efficacy and safety of intravenous iron formulations. However, evidence in pediatric age remains scarce and no clinical recommendations exist for the diagnosis and treatment of this particular age group. The present document represents the first national consensus on the management of anemia in pediatric IBD and is therefore particularly relevant. The authors anticipate that the proposed recommendations will be useful in daily clinical practice for diagnosing and managing iron deficiency and iron-deficiency anemia in the pediatric population with IBD. ResumoA anemia é uma manifestação extra-digestiva frequente associada à doença inflamatória intestinal, tanto na população pediátrica como adulta, sendo a anemia por défice de ferro a sua forma mais frequente. Constitui uma comorbilidade clinicamente relevante, com repercussão na qualidade de vida. Deve ser atempadamente diagnosticada e adequadamente tratada. A estratégia terapêutica atualmente aceite preconiza uma atitude interventiva. Neste contexto, a evidência científica atual tem demonstrado a eficácia e segurança da utilização das formulações de ferro endovenoso. Contudo, em idade pediátrica a evidência ainda é insuficiente, não existindo orientações de abordagem diagnóstica ou terapêutica especificamente dirigidas a este grupo etário. Este é o primeiro consenso nacional sobre a abordagem da anemia na doença inflamatória intestinal pediátrica, revestindo-se por isso de particular relevância. Pretende-se que este documento tenha utilidade e aplicabilidade na prática clínica na avaliação e seguimento do défice de ferro e anemia por défice de ferro em doentes pediátricos com doença inflamatória intestinal.

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Slow Hematological Recovery in Children With IBD‐associated Anemia in Cases of “Expectant Management”

Abstract: Hematological recovery in children with IBD-associated anemia is slow with expectant management, regardless of the type of anemia at T0. Present results underline the need for a more active approach to improve Hb.

Cited by 22 publications

References 27 publications

Effectiveness and safety of ferric carboxymaltose treatment in children and adolescents with inflammatory bowel disease and other gastrointestinal diseases

Effectiveness and safety of ferric carboxymaltose treatment in children and adolescents with inflammatory bowel disease and other gastrointestinal diseases

Nutrition in Pediatric Inflammatory Bowel Disease

Portuguese Consensus on Diagnosis, Treatment, and Management of Anemia in Pediatric Inflammatory Bowel Disease

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