scholarly journals Gastric Siderosis and Ulceration from Intravenous Iron Supplementation Manifesting as Chronic Upper Gastrointestinal Bleeding: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Donald Ewing ◽  
Ava Brozovich ◽  
Ethan Burns ◽  
Gonzalo Acosta ◽  
Courtney Hatcher ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Gastrointestinal Bleeding ◽  
Iron Supplementation ◽  
Upper Gastrointestinal Bleeding ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Red Blood Cell Transfusions ◽  
Upper Gastrointestinal ◽  
Intravenous Iron Supplementation

Iron deficiency is the most common etiology of anemia worldwide and is often managed with varying methods of iron supplementation. Although rare, oral iron supplementation can perpetuate iron deficiency anemia by causing gastric ulceration and upper gastrointestinal bleeding in high-risk populations. However, this complication has not been previously described with intravenous iron supplementation. We present a case of a 63-year-old male with severe iron deficiency anemia on biweekly intravenous iron infusions and weekly packed red blood cell transfusions who presented with melena over several months. Upper endoscopy demonstrated a clean-based gastric body ulcer and nonbleeding gastric varices. Histology of the gastric ulcer was suggestive of iron-induced gastric mucosal injury. This case demonstrates that frequent utilization of intravenous iron and packed red blood cell transfusions may predispose certain patients to the development of iron-induced gastritis and ulceration.

scholarly journals Gastric Inflammatory Fibroid Polyp: A Rare Cause of Occult Upper Gastrointestinal Bleeding

2020 ◽  
Vol 8 ◽  
pp. 232470962093684
Author(s):  
Faisal Inayat ◽  
Asad Ur Rahman ◽  
Ahsan Wahab ◽  
Amir Riaz ◽  
Effa Zahid ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Gastrointestinal Bleeding ◽  
Iron Deficiency Anemia ◽  
Upper Gastrointestinal Bleeding ◽  
Therapeutic Modality ◽  
Deficiency Anemia ◽  
Resected Specimen ◽  
Fecal Occult Blood ◽  
Presenting Symptoms ◽  
Upper Gastrointestinal

Inflammatory fibroid polyps (IFPs) are rare mesenchymal lesions that can arise throughout the gastrointestinal tract. These tumors represent less than 0.1% of all gastric polypoid lesions and are frequently found incidentally on endoscopic evaluation. While presenting symptoms depend on the location of the tumor, gastric polyps commonly present with epigastric pain and early satiety. We hereby delineate the case of a middle-aged female who presented with chronic iron deficiency anemia and a positive fecal occult blood test. She underwent an upper endoscopy, which revealed an actively oozing umbilicated lesion in the gastric antrum. Endoscopic ultrasound divulged the submucosal origin of the lesion. It was subsequently excised using endoscopic mucosal resection. Pathologic examination of the resected specimen confirmed the diagnosis of gastric IFP. Furthermore, we conducted a systematic literature search of the MEDLINE database centered on gastric IFPs from January 2000 till March 2020. The data on patient demographics, clinical features, endoscopic findings, lesion site and size, and treatment approaches were collected and analyzed. This article illustrates the overarching need for clinicians to be vigilant of gastric IFPs presenting with initial clinical symptoms suggestive of occult upper gastrointestinal bleeding. Prompt diagnosis and management of gastric IFPs carry paramount importance to combat chronic unexplained iron deficiency anemia following occult bleeding in such patients. A concoction of endoscopy, biopsy, and immunohistochemical examination can be employed toward their prompt detection. Although gastric IFPs have conventionally been treated with surgery, endoscopic resection is now emerging as a safe and efficient therapeutic modality.

scholarly journals Usefulness of Reticulocyte Hemoglobin Equivalent in Management of Regular Hemodialysis Patients with Iron Deficiency Anemia

2016 ◽  
Vol 54 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Naomi Niari Dalimunthe ◽  
Abdurrahim Rasyid Lubis
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Supplementation ◽  
Intravenous Iron ◽  
Hemodialysis Patients ◽  
Deficiency Anemia ◽  
Dialysis Session ◽  
Early Predictor ◽  
Regular Hemodialysis ◽  
Intravenous Iron Supplementation

Introduction. Reticulocyte hemoglobin equivalent (RET-He) is a new parameter for evaluating iron status. This study aims to assess diagnostic value and investigate RET-He as early predictor of response to intravenous iron supplementation. Methods. Seventy-two regular hemodialysis patients at Adam Malik Hospital were studied from April to May 2011. RET-He was compared with conventional iron parameters for identification of iron deficiency. Fifteen patients with iron deficiency anemia were selected to receive 100 mg iron sucrose intravenous during every dialysis session (2x/weeks) for 4 weeks. Results. Receiver operating characteristic (ROC) curve for RET-He revealed the value of area under the curve was 0.818 (p < 0.0001). Using cutoff level 31.65 pg, RET-He showed 81.5% sensitivity and 61.6% specificity. Serum ferritin (r = 0.499, p < 0.0001) and transferrin saturation/ TSAT (r = 0.592, p<0.0001) were correlated to RET-He. Significant improvement in hemoglobin, hematocrit and RET-He were found after intervention (p = 0.023, p = 0.049 and p = 0.019, respectively). Conclusion. RET-He is a useful marker of iron deficiency and early predictor of response to intravenous iron supplementation in regular hemodialysis patients.

scholarly journals Preoperative intravenous iron treatment reduces postoperative complications and postoperative anemia in preoperatively anemic patients with colon carcinoma

2021 ◽  
Author(s):  
Mikael Kangaspunta ◽  
Jorma Mäkijärvi ◽  
Selja Koskensalo ◽  
Arto Kokkola ◽  
Perttu Arkkila ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Postoperative Complications ◽  
Blood Cell ◽  
Cancer Patients ◽  
Iron Supplementation ◽  
Intravenous Iron ◽  
Colon Resection ◽  
Iron Treatment ◽  
Red Blood Cell Transfusions ◽  
Intravenous Iron Supplementation

Abstract Purpose Anemia is common among patients with colorectal cancer and is associated with an increased risk of complications and poorer survival rate. The main objective of our study was to determine the effect of preoperative intravenous iron supplementation therapy on the need for red blood cell transfusions, other postoperative complications, and length of hospital stay in colon cancer patients undergoing colon resection. Methods In this retrospective cohort study, data were collected from medical records of all 549 colon carcinoma patients who underwent a colon resection in Helsinki University Hospital during the years 2017 and 2018. The patients were divided into two cohorts: one with anemic patients treated with preoperative intravenous iron supplementation therapy (180 patients) and one with anemic patients without preoperative intravenous iron supplementation therapy (138 patients). Non-anemic patients and patients requiring emergency surgery were excluded (231 patients). Results Patients treated with intravenous iron had less postoperative complications (33.9% vs. 45.9%, p = 0.045) and a lower prevalence of anemia at 1 month after surgery (38.7% vs. 65.3%, p < 0.01) when compared with patients without preoperative iv iron treatment. No difference was found in the amount of red blood cell transfusions, length of stay, or mortality between the groups. Conclusion This is the first study demonstrating a significant decrease in postoperative complications in anemic colon cancer patients receiving preoperative intravenous iron supplementation therapy. This treatment also diminishes the rate of postoperative anemia, which is often associated with a facilitated recovery.

scholarly journals A Rare Complication of Hyperplastic Gastric Polyp

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Suresh Kumar Nayudu ◽  
Masooma Niazi ◽  
Bhavna Balar ◽  
Kavitha Kumbum
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Outlet Obstruction ◽  
American Woman ◽  
Gastric Polyp ◽  
Deficiency Anemia ◽  
Surgical Specimen ◽  
Gastric Polyps ◽  
Therapeutic Benefits ◽  
Upper Gastrointestinal

Hyperplastic gastric polyps are incidentally diagnosed during upper gastrointestinal endoscopy. They are known to cause gastric outlet obstruction and chronic blood loss leading to iron deficiency anemia. However, hyperplastic gastric polyp presenting as acute severe upper gastrointestinal bleeding is very rare. To the best of our knowledge, there have been two cases of hyperplastic gastric polyps presenting as acute gastrointestinal bleeding in the medical literature. We present a case of a 56-year-old African American woman who was admitted to our hospital with symptomatic anemia and sepsis. The patient developed acute upper gastrointestinal bleeding during her hospital stay. She underwent emergent endoscopy, but bleeding could not be controlled. She underwent emergent laparotomy and wedge resection to control the bleeding. Biopsy of surgical specimen was reported as hyperplastic gastric polyp. We recommend that physicians should be aware of this rare serious complication of hyperplastic gastric polyps as endoscopic polypectomy has diagnostic and therapeutic benefits in preventing future complications including bleeding.

scholarly journals Red Blood Cell Transfusions and Iron Therapy for Patients Presenting with Acute Upper Gastrointestinal Bleeding: A Survey of Canadian Gastroenterologists and Hepatologists

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Kyle J. Fortinsky ◽  
Myriam Martel ◽  
Roshan Razik ◽  
Gillian Spiegle ◽  
Zane R. Gallinger ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Limited Data ◽  
Web Based ◽  
Initial Management ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Clinical Vignettes ◽  
Red Blood Cell Transfusions ◽  
Artery Disease ◽  
Upper Gastrointestinal

Introduction. There is limited data evaluating physician transfusion practices in patients with acute upper gastrointestinal bleeding (UGIB).Methods. A web-based survey was sent to 500 gastroenterologists and hepatologists across Canada. The survey included clinical vignettes where physicians were asked to choose transfusion thresholds.Results. The response rate was 41% (N=203). The reported hemoglobin (Hgb) transfusion trigger differed by up to 50 g/L. Transfusions were more liberal in hemodynamically unstable patients compared to stable patients (mean Hgb of 86.7 g/L versus 71.0 g/L;p<0.001). Many clinicians (24%) reported transfusing a hemodynamically unstable patient at a Hgb threshold of 100 g/L and the majority (57%) are transfusing two units of RBCs as initial management. Patients with coronary artery disease (mean Hgb of 84.0 g/L versus 71.0 g/L;p<0.01) or cirrhosis (mean Hgb of 74.4 g/L versus 71.0 g/L;p<0.01) were transfused more liberally than healthy patients. Fewer than 15% would prescribe iron to patients with UGIB who are anemic upon discharge.Conclusions. The transfusion practices of gastroenterologists in the management of UGIB vary widely and more high-quality evidence is needed to help assess the efficacy and safety of selected transfusion thresholds in varying patients presenting with UGIB.

scholarly journals Red blood cell transfusion is associated with further bleeding and fresh-frozen plasma with mortality in nonvariceal upper gastrointestinal bleeding

Transfusion ◽  
2015 ◽  
Vol 56 (4) ◽  
pp. 816-826 ◽  
Author(s):  
Kavitha Subramaniam ◽  
Katrina Spilsbury ◽  
Oyekoya T. Ayonrinde ◽  
Faye Latchmiah ◽  
Syed A. Mukhtar ◽  
...  
Keyword(s):  
Blood Cell ◽  
Gastrointestinal Bleeding ◽  
Red Blood Cell ◽  
Upper Gastrointestinal Bleeding ◽  
Fresh Frozen Plasma ◽  
Red Blood Cell Transfusion ◽  
Fresh Frozen ◽  
Upper Gastrointestinal ◽  
Frozen Plasma
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