A clinical case of severe iron deficiency anemia in a patient with hiatal hernia

2021 ◽  
pp. 104-109
Author(s):  
D. V. Lukanin ◽  
A. A. Sokolov ◽  
A. A. Sokolov ◽  
M. S. Klimenko

Among the many reasons for the development of iron deficiency anemia, chronic blood loss from Cameron ulcers, developing with hiatal hernias, is gaining increasing clinical significance. Nevertheless, doctors of various specialties still have limited knowledge about the role of this pathology in the depletion of the iron depot, the specifics of instrumental verification of the diagnosis, and the possibilities of surgical technologies in the complex treatment of patients with this disease. The described case illustrates the long-term course of severe iron deficiency anemia in a patient with hiatal hernia (type III) due to latent blood loss from Cameron ulcers. The use of a therapeutic algorithm, which included complex conservative therapy followed by laparoscopic surgery to eliminate the hiatal hernia, led to a complete recovery of the patient.

Author(s):  
Stefanie Howaldt ◽  
Eugeni Domènech ◽  
Nicholas Martinez ◽  
Carsten Schmidt ◽  
Bernd Bokemeyer

Abstract Background Iron-deficiency anemia is common in inflammatory bowel disease, requiring oral or intravenous iron replacement therapy. Treatment with standard oral irons is limited by poor absorption and gastrointestinal toxicity. Ferric maltol is an oral iron designed for improved absorption and tolerability. Methods In this open-label, phase 3b trial (EudraCT 2015-002496-26 and NCT02680756), adults with nonseverely active inflammatory bowel disease and iron-deficiency anemia (hemoglobin, 8.0-11.0/12.0 g/dL [women/men]; ferritin, <30 ng/mL/<100 ng/mL with transferrin saturation <20%) were randomized to oral ferric maltol 30 mg twice daily or intravenous ferric carboxymaltose given according to each center’s standard practice. The primary endpoint was a hemoglobin responder rate (≥2 g/dL increase or normalization) at week 12, with a 20% noninferiority limit in the intent-to-treat and per-protocol populations. Results For the intent-to-treat (ferric maltol, n = 125/ferric carboxymaltose, n = 125) and per-protocol (n = 78/88) analyses, week 12 responder rates were 67% and 68%, respectively, for ferric maltol vs 84% and 85%, respectively, for ferric carboxymaltose. As the confidence intervals crossed the noninferiority margin, the primary endpoint was not met. Mean hemoglobin increases at weeks 12, 24, and 52 were 2.5 vs 3.0 g/dL, 2.9 vs 2.8 g/dL, and 2.7 vs 2.8 g/dL with ferric maltol vs ferric carboxymaltose. Treatment-emergent adverse events occurred in 59% and 36% of patients, respectively, and resulted in treatment discontinuation in 10% and 3% of patients, respectively. Conclusions Ferric maltol achieved clinically relevant increases in hemoglobin but did not show noninferiority vs ferric carboxymaltose at week 12. Both treatments had comparable long-term effectiveness for hemoglobin and ferritin over 52 weeks and were well tolerated.


2021 ◽  
pp. 1-10
Author(s):  
Pablo E. Pergola ◽  
Diogo Belo ◽  
Paul Crawford ◽  
Moustafa Moustafa ◽  
Wenli Luo ◽  
...  

<b><i>Introduction:</i></b> Ferric citrate (FC) is indicated as an oral iron replacement for iron deficiency anemia in adult patients with chronic kidney disease (CKD) not on dialysis. The recommended starting dose is one 1-g tablet three times daily (TID). This study investigated long-term efficacy and safety of different FC dosing regimens for treating anemia in nondialysis-dependent CKD (NDD-CKD). <b><i>Methods:</i></b> In this phase 4, randomized, open-label, multicenter study, patients with anemia with NDD-CKD (estimated glomerular filtration rate, ≥20 mL/min and &#x3c;60 mL/min) were randomized 1:1 to one FC tablet (1-g equivalent to 210 mg ferric iron) TID (3 g/day) or 2 tablets twice daily (BID; 4 g/day). At week 12, dosage was increased to 2 tablets TID (6 g/day) or 3 tablets BID (6 g/day) in patients whose hemoglobin (Hb) levels increased &#x3c;0.5 g/dL or were &#x3c;10 g/dL. Primary endpoint was mean change in Hb from baseline to week 24. <b><i>Results:</i></b> Of 484 patients screened, 206 were randomized and 205 received FC. Mean (standard deviation) changes from baseline in Hb at week 24 were 0.77 (0.84) g/dL with FC TID 3 g/day and 0.70 (0.98) g/dL with FC BID 4 g/day. <b><i>Discussion/Conclusions:</i></b> FC administered BID and TID for 48 weeks was safe and effective for treating anemia in this population, supporting potentially increased dosing flexibility.


2019 ◽  
Vol 104 (3) ◽  
pp. 153-161 ◽  
Author(s):  
Benjamin Elstrott ◽  
Lubna Khan ◽  
Sven Olson ◽  
Vikram Raghunathan ◽  
Thomas DeLoughery ◽  
...  

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Peng Yong Sim ◽  
Priyal Taribagil ◽  
Ione O. C. Woollacott ◽  
Safina Rashid ◽  
Desmond P. Kidd

Abstract Background The presentation of idiopathic intracranial hypertension (IIH) in association with iron deficiency anemia (IDA) is rare. Case presentation This case report depicts the unusual case of a 31-year-old woman of mixed Jamaican and English heritage with IIH who presented initially as IDA in the context of menorrhagia. Subsequent ophthalmic review, lumbar puncture, cerebrospinal fluid analysis and neuroimaging studies revealed severe bilateral optic disc swelling and raised intracranial pressure in keeping with IIH. Prompt treatment of IDA with blood transfusion and orally administered iron supplements, in addition to medical treatment for IIH, contributed to significant improvement of symptoms and prevented long-term visual deficits. Conclusion The possibility of IDA, albeit rare, should always be considered and investigated appropriately in all patients with IIH, as the treatment of the anemia alone may be sight-saving.


Author(s):  
OJS Admin

Depression is a public health disorder, ranking third after respiratory and cardiac diseases. There were many evidences that iron deficiency anemia (IDA) is one of the foremost causes regarding nutritional pointof view for depression. We reviewed these evidences that IDAlinking to depression. We identified seventeen studies in four databases including randomized-controlled trials (RCTs) and observational studies assessing the impact of IDAand iron supplementation on the risk of depression. We extracted data on the basis of sample size, geographical region, measures of depression, hemoglobin, iron levels and intake of iron supplementation and critically appraised the results from the studies. Eleven out of sixty one studies were experimental, which indicated that dietary supplementation particularly iron supplementation had an association (r − 0.19 to −0.43 and ORs 1.70–4.64) with severity of depression. Evidences showed that women of reproductive age were more vulnerable to iron deficiency anemia than other population. Low ferritin and low hemoglobin level were associated with severity of depression. Iron is an essential nutrient for all living creatures, as a cofactor of various enzymes and plays significant role in environmental stimulant for the articulation of numerous virulence factors. Many clinical problems are caused by iron deficiency. Therefore, this review intended to highlight the important role of iron supplementation in reducing the severity of depression.


Author(s):  
Rabaa Khaled Abdel Salam ◽  
Saria Naji Mohsin

This study was conducted to identify the role of some blood parameters, levels of some hormones, proteins, and cellular kinetics that have a role in iron transport and storage, in addition to their relationship with each other and with blood and sex parameters for patients with severe and moderate iron deficiency anemia, and to compare the parameters with healthy people. The study period lasted for the period from (December 2020 until March 2021) The presence of iron deficiency anemia was confirmed by examining the blood picture and the criteria of hepcidin and ferritin. The results showed a significant decrease in the in the concentration of hepcidin, ferritin and iron in patients compared to the control group.


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