scholarly journals P537 Anemia in Crohn’s Disease: Response to treatment and risk of recurrence

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S510-S510
Author(s):  
G Gharbi ◽  
N Bibani ◽  
M Sabbah ◽  
B Nawel ◽  
D Trad ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Iron Deficiency ◽  
Crohn's Disease ◽  
Iron Deficiency Anemia ◽  
Ferritin Level ◽  
Response To Treatment ◽  
Deficiency Anemia ◽  
Severe Anemia ◽  
Active Disease ◽  
Anemia Treatment

Abstract Background Anemia is common in Crohn’s Disease (CD). Iron deficiency and inflammation are the most common etiologies. The aim of our study is to assess the response of patients with CD to anemia treatment , as well as the predisposing factors for recurrence after treatment. Methods This is a retrospective study including patients with CD complicated by anemia, treated in the gastroenterology department between January 2015 and December 2019. Iron deficiency anemia is defined by a ferritin level <50 ng /ml, it is inflammatory if the CRP level is high with a ferritin level which exceeds 100 ng/ml and mixed if this later ranges between 50 and 100 ng/ml. Results Fifty-four patients were included with a M / F sex ratio of 1.3. The mean age was 40.5 years old with a mean age at diagnosis of CD of 29 years old. Patients had ileal or ileocolic involvement in 82.2% of cases and pure colonic involvement in 16.7%. The main symptoms of anemia were asthenia (64.8%) and mucocutaneous pallor (42.6%). Severe anemia was noted in 64.8% of patients. The factors statistically associated with severe anemia were: the number of relapses before the diagnosis of anemia (p= 0.012), an active disease (p = 00.024) assessed by the CDAI score, the presence of a deficiency syndrome, in particular hypocholesterolemia (p= 0.007) and hypocalcemia (p= 0.006). The anemia was inflammatory in 44.4% of patients, iron deficiency in 31.7%, mixed in 20.4% and vitamin B12 deficiency in 16.7% of them. Treatment of anemia depending on the etiology was effective in 72% of patients. The response was partial in 24% of cases. Only 4% of patients did not respond to treatment. The predictive factors of a poor response to anemia treatment were: the disease duration (p= 0.05), an active disease at the time of diagnosis of anemia (p= 0.025) and an extended ileal resection (p= 0.005). Patients with inflammatory anemia responded better to treatment (p= 0.006). A longer duration of iron suplementation (p = 0.02), as well as the route of administration (IV) (p= 0.014) were correlated with a better response to therapy in case of iron deficiency anemia. Recurrence of anemia was observed in 84.3% of patients with a mean time after anemia correction of 11.5 months. Serum ferritin levels <20 ng/ml during follow-up was the main risk factor for recurrence of anemia (p= 0.01). Conclusion Even after treatment, recurrence of anemia is common especially in patients followed for CD with ileal involvement. A clinical-biological remission, a sufficient duration of iron treatment and the control of the response to treatment by the dosage of the ferritin level even after the correction of the anemia is necessary in order to avoid this recurrence and thus ensure a better quality of life .

scholarly journals Can asymptomatic Chron’s disease be diagnosed in patients with iron deficiency anemia by CT-enterograhpy?

2021 ◽  
Vol 38 (SI-1) ◽  
pp. 71-73
Author(s):  
Ufuk AVCIOĞLU ◽  
Ayşegül İDİL SOYLU
Keyword(s):  
Small Intestine ◽  
Crohn’S Disease ◽  
Iron Deficiency ◽  
Crohn's Disease ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Diagnostic Utility ◽  
Pathological Findings ◽  
Ct Enterography ◽  
Chron's Disease

It is difficult to diagnose Crohn's disease in the asymptomatic period. The aim of this study is to evaluate the diagnostic utility of CT enterography (CTE) in the diagnosis of asymptomatic Crohn's disease (CD) with small intestine involment in patients with iron deficiency anemia (IDA). 250 patients who underwent CTE examination between 2017 and 2018 were retrospectively scanned. 45 patients who had endoscopic examinations and diagnosed with IDA were included in the study. While one or more pathological findings to explain IDA were observed in 31 (68%) patients with endoscopic examinations, findings that could be explained as CD sequelae were observed in 4 (8.8%) patients. No lesions were observed by CTE in 10 (22.2%) patients. Diagnosis is difficult in mild forms of Crohn’s disease or in periods of remission. In this period, CTE can contribute to the diagnosis as it can also show extraluminal findings.

scholarly journals Iron deficiency anemia: current strategies for the diagnosis and management

2013 ◽  
Vol 4 (3) ◽  
pp. 193-202 ◽  
Author(s):  
Zühre Kaya
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Binding Capacity ◽  
Ferritin Level ◽  
Nutritional Deficiencies ◽  
Deficiency Anemia ◽  
Iron Level ◽  
Serum Iron Level ◽  
Diagnosis And Management ◽  
Low Serum

Iron deficiency is one of the commonest nutritional deficiencies in the world. It is multifactorial and may be caused by lack of intake, blood loss and intestinal causes. Clinical features are highly variable, and most patients are asymptomatic. Typical laboratory features of iron deficiency anemia (IDA) include a hypochromic microcytic anemia, low serum iron level, high total iron binding capacity, low serum ferritin level. Usefulness of monitoring serum transferrin receptor level (sTfR) and hepcidin for identifying IDA have been examined in a few studies. Available data suggest that sTfR can potentially become a valuable tool for regular testing of patients in the future. Despite IDA is easily corrected with iron therapy, establishing the cause can be difficult, particularly in cases caused by disorders of iron transport. Education for clinician needs to focus on increasing awareness of the importance of failure respond to iron supplementation. The aim of this review was to outline the current strategies for the diagnosis and management of IDA in the light of the latest reports.

scholarly journals Upper Gastrointestinal Crohn’s Disease: Literature Review and Case Presentation

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Soorya N. Aggarwal ◽  
Yana Cavanagh ◽  
Lan Wang ◽  
Amer Akmal ◽  
Matthew A. Grossman
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Iron Deficiency ◽  
Crohn's Disease ◽  
Fecal Calprotectin ◽  
Upper Gastrointestinal Tract ◽  
Laboratory Evaluation ◽  
Deficiency Anemia ◽  
Endoscopic Evaluation ◽  
Upper Gastrointestinal

Upper gastrointestinal tract predominant Crohn’s Disease (CD) remains an elusive clinical entity, manifesting limited or vague symptomatology, eluding clinical suspicion, and delaying subsequent diagnostic evaluation. As a result, it has not been widely described and there is a lack of clear recommendations for diagnosis or management. Standard IBD evaluation including serologic testing, imaging, and endoscopy may initially not be fruitful. Furthermore, endoscopic evaluation may be grossly normal in patients without long standing-disease. We describe an 18-year-old male who presented with only unexplained, persistent iron-deficiency anemia. Extensive outpatient testing including multiple endoscopic evaluations with standard biopsies was unfruitful. Ultimately, a positive fecal calprotectin prompted enteroscopy with endoscopic mucosal resection (EMR) in an effort to obtain a larger, deeper tissue specimen. Grossly cobblestoned mucosa along with histopathology revealing focal crypt abscesses, chronic inflammation in the lamina propria, and superficial foveolar epithelial regenerative changes were consistent with CD. This patient’s case illustrates the need for a high degree of suspicion for CD in patients with unexplained or persistent iron deficiency anemias. Persistent investigation yielded an elevation in fecal calprotectin suggesting underlying gastrointestinal inflammation and prompted advanced endoscopic evaluation with EMR. Waxing and waning tissue findings are characteristic of CD and pose a unique challenge in patients with upper gastrointestinal predominant pathology. As such, diligent workup including laboratory evaluation, imaging, and serial endoscopy is critical to establish pathology and dictate subsequent management in IBD, especially upper gastrointestinal tract predominant CD.

scholarly journals Prevalence and causes of iron deficiency anemias in infants aged 9 to 12 months in Estonia

Medicina ◽  
2007 ◽  
Vol 43 (12) ◽  
pp. 947 ◽  
Author(s):  
Neve Vendt ◽  
Heli Grünberg ◽  
Sirje Leedo ◽  
Vallo Tillmann ◽  
Tiina Talvik
Keyword(s):  
Risk Factor ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Mean Corpuscular Volume ◽  
Ferritin Level ◽  
Solid Food ◽  
Deficiency Anemia ◽  
Corpuscular Volume ◽  
Main Risk Factor ◽  
Ferritin Concentration

Objective. To investigate the prevalence and causes of iron deficiency anemia in infants aged 9 to 12 months in Estonia. Material and methods. Every second child aged 9–12 months was randomly selected from primary medical centers in seven counties from all over Estonia. A questionnaire concerning eating habits and lifestyle was sent to their parents. Sixty-five percent (n=195) of contacted families agreed to participate in the study. Mean corpuscular volume and hemoglobin, serum ferritin, and soluble transferrin receptor levels were measured in 171 infants. Anemia was defined when hemoglobin level was lower than 105 g/L, and iron deficiency when ferritin level and mean corpuscular volume were lower than 12 µg/L and 74 fL, respectively. Results. The prevalence of iron deficiency was 14.0% and iron deficiency anemia 9.4%. Birthweight less than 3000 g was the main risk factor for iron deficiency (OR=9.4; P<0.0005). Infants fed with breast milk and solid food had lower ferritin concentration (18.5 µg/L, 95% CI 14.0–23.0) than infants fed with formula and solid food (32.8 µg/L, 95% CI 26.6–39) (P<0.005). Conclusion. Iron deficiency anemia is common among 9–12-month-old Estonian infants. The main risk factor for iron deficiency was birthweight less than 3000 g.

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