scholarly journals P405. Pediatric Crohn's disease with iron deficiency anemia: A follow-up study of intravenous iron treatment

2015 ◽  
Vol 9 (suppl 1) ◽  
pp. S281-S281
Author(s):  
Gökhan Pektaş ◽  
İsmail Kırlı

Objective: This study aims to clarify the effects of intravenous iron supplementation on biomarkers for oxidative stress in women with iron deficiency anemia. Methods: This is a cross-sectional review of 40 healthy women and 40 women who underwent intravenous iron treatment due to anemia. Biochemical markers for oxidative stress were determined for both healthy controls and anemic patients. These markers were also evaluated at hour 1 and day 30 of intravenous iron treatment. Results: The patients with anemia had significantly higher catalase activity and total oxidant status (TOS) but significantly lower nitrate and total anti-oxidant status (TAS) than the healthy controls (p=0.0245, p<0.0001, p=0.0437 and p<0.0001 respectively). At hour 1 of intravenous iron treatment, nitrate, nitrite, nitric oxide, total thiol and TAS values were significantly lower and TOS values were significantly higher than those before the administration of treatment (p=0.0322, p=0.0003, p=0.0005, p<0.0001, p<0.0001 and p=0.004). At day 30 of intravenous iron treatment, catalase activity, nitrate, total thiol and TOS values were significantly lower than those before the administration of treatment (p=0.0332, p=0.0015, p=0.0391 and p<0.0001 respectively) and at hour 1 of treatment (p=0.0498, p<0.0001, p=0.0004 and p<0.0001 respectively). At day 30 of intravenous iron treatment, nitric oxide and TAS values were significantly higher than those before the administration of treatment (p=0.0480 and p=0.001 respectively) and at hour 1 of treatment (p<0.0001 for both). Conclusion: Intravenous iron replacement prompts oxidative stress at hour 1 of infusion in adults with anemia but this increase resolves partially in the following 30 days.


2007 ◽  
Vol 107 (6) ◽  
pp. 923-927 ◽  
Author(s):  
Oliver M. Theusinger ◽  
Pierre-François Leyvraz ◽  
Urs Schanz ◽  
Burkhardt Seifert ◽  
Donat R. Spahn

Background Preoperative anemia is frequent in patients undergoing orthopedic surgery. The purpose of this study was to assess the preoperative increase of hemoglobin in iron deficiency anemia patients treated with intravenous iron. Methods After obtaining written informed consent, 20 patients with iron deficiency anemia received 900 mg intravenous iron sucrose over 10 days starting 4 weeks before surgery. Changes of hemoglobin and iron status were measured over 4 weeks and at discharge. In the last 11 patients, endogenous erythropoietin was also measured. Data were analyzed using the Friedman test followed by pairwise Wilcoxon signed rank tests with Bonferroni correction. Results Hemoglobin increased significantly (P &lt; 0.0001) after intravenous iron treatment. Overall, the mean maximum increase was 1.0 +/- 0.6 g/dl (range, 0.2-2.2 g/dl). Ferritin increased from 78 +/- 70 to 428 +/- 191 microg/l (P = 0.0001), ferritin index decreased from 2.7 +/- 2.4 to 1.5 +/- 1.0 (P = 0.0001), and soluble transferrin receptor decreased from 4.1 +/- 2.3 mg/l to 3.7 +/- 2.3 mg/l (P = 0.049), whereas transferrin saturation (20.5 +/- 9.0 to 22.9 +/- 9.0%) and serum iron (13.3 +/- 4.6 to 13.1 +/- 4.5 microm) did not change significantly after intravenous iron treatment. Endogenous erythropoietin decreased from 261 +/- 130 pg/ml to 190 +/- 49 pg/ml 2 weeks after intravenous iron treatment (P = 0.050, not significant after Bonferroni correction). No adverse events related to intravenous iron were observed. The maximum increase of hemoglobin was observed 2 weeks after the start of intravenous iron treatment, indicating that administration of intravenous iron 2-3 weeks before surgery may be optimal. Conclusion Treatment with intravenous iron allows correcting iron deficiency anemia before elective surgery.


2021 ◽  
Vol 28 (04) ◽  
pp. 481-484
Author(s):  
Hira Jamal ◽  
Humaira Zafar ◽  
Mubashra Naz ◽  
Umber Fatima ◽  
Anees Fatima

Objective: To compare the mean increase in hemoglobin level with ferric carboxymaltose injection and iron sucrose injection for the management of the pregnant females presenting with iron deficiency anemia. Study Design: Randomized Controlled Trial. Settings: Department of Obstetrics and Gynecology Madina Teaching Hospital affiliated with University medical and Dental College Faisalabad. Period: July 2019 to December 2019. Material & Method: A total number of 100 patients presented in OPD satisfying the selection criteria were enrolled in the study after permission from ethical committee. On enrollment, a detailed clinical history which include previous iron treatment including and chronic medical disorders was taken. Clinical examination was done. Investigations for anemia include hemoglobin, reticulocyte count, peripheral film and red cell indices, serum ferritin level and Hb electrophoresis if indicated. The patients were randomly divided in two groups. In group A, females were given ferric carboxymaltose and in group B, females were given iron sucrose. After calculating the total iron deficit, patients in group A were given intravenous FCM. Patients in group B were given IS. Follow up of the patient was done after 3 weeks of intravenous iron treatment. The baseline Hb and values after 3 weeks of intravenous iron treatment were compared between the FCM and IS groups and increase in Hb level calculated as mean and SD. Both groups were analyzed for rise in Hb level by using independent sample t test. P value < 0.05 was taken as significant. Results: A total 100 pregnant female were found eligible for study, and were randomized into two groups of 50 each. Mean increase in hemoglobin level with ferric carboxymaltose and iron sucrose was evaluated, it shows that baseline Hb was 8.84±0.68 in Group A and 8.78 ±0.76 in Group B, P value was 0.67, after treatment Hb was 12.02±0.89 in Group A and 10.92 ±0.99 in Group B. Mean increase was 3.18 ±0.60 in Group A and 2.14±0.81 in Group B. P value was 0.001. Conclusion: Ferric carboxymaltose significantly increase Hb level and restores the iron stores as compare to iron sucreose. FCM is safe and effective intravenous treatment for iron deficiency anemia in pregnancy. FCM has the advantages of single large dose administration and fewer hospital visit. FCM is most suitable drug for the treatment of patients with IDA who required quick replenishment of iron stores.


2021 ◽  
Vol 38 (SI-1) ◽  
pp. 71-73
Author(s):  
Ufuk AVCIOĞLU ◽  
Ayşegül İDİL SOYLU

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.


2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S510-S510
Author(s):  
G Gharbi ◽  
N Bibani ◽  
M Sabbah ◽  
B Nawel ◽  
D Trad ◽  
...  

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 &lt;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 &lt;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 .


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