Journal of Isfahan Medical School

Journal of Isfahan Medical School

Assessment of Anemia in Patients with Various Types of Inflammatory Bowel Disease under Medical Therapy

Document Type : Original Article (s)

Authors
Seyed Mohammad Hassan Emami 1
Ali Gharavinia 2
Mohammad Emadoddin Habibi 2
Farzaneh Habibi 2
Sadegh Baradaran-Mahdavi 2
Abdalmahdi Baghaei 3
1 Professor, Poursina Hakim Digestive Diseases Research Center (PDRC) AND Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Internist, Poursina Hakim Digestive Diseases Research Center (PDRC) AND School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.22122/jims.v36i490.10351
Abstract
Background: Anemia is a usual systemic complication of inflammatory bowel disease (IBD) and can be presented in combination of iron deficiency anemia (IDA) and anemia of chronic disease (ACD). In the present study, anemia in IBD was assessed.Methods: This was a cross-sectional study conducted on 25 patients with Crohn’s disease (CD), 49 patients with ulcerative colitis (US), and 14 patients with undetermined colitis in years 2016-17. Hematological indices including ferritin, transferring saturation, hemoglobin, mean corpuscular volume (MCV), vitamin B12, and folate were measured. Demographic information and region of intestinal involvement were compared as well.Findings: Based on gender distribution, anemia was not significantly different between Crohn’s disease, ulcerative colitis, or undetermined colitis (P = 0.89). In addition, type of anemia including iron deficiency anemia, anemia of chronic disease, and macrocytic anemia was not different (P = 0.97) between the colitis types. Anemia was not in association with site of intestinal involvement (P = 0.89).Conclusion: Based on the findings of the current study, anemia is not statistically associated with type of bowel involvement, and site of bowel involvement. Further studies are recommended.
Keywords
Inflammatory bowel disease
Anemia
Iron-deficiency anemia
Chronic Disease
Anemia, Macrocytic
  1. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005; 352(10): 1011-23.
  2. Weiss G, Gasche C. Pathogenesis and treatment of anemia in inflammatory bowel disease. Haematologica 2010; 95(2): 175-8.
  3. Gomollon F, Gisbert JP. Anemia and inflammatory bowel diseases. World J Gastroenterol 2009; 15(37): 4659-65.
  4. Goncalves TC, Monteiro S, Barbosa M, Moreira MJ, Cotter J. Iron-deficiency without anemia in crohn's disease: What are the predictive factors of recovery? Gastroenterology 2017; 152(5 Suppl 1): S783.
  5. Cucino C, Sonnenberg A. Cause of death in patients with inflammatory bowel disease. Inflamm Bowel Dis 2001; 7(3): 250-5.
  6. Pizzi LT, Weston CM, Goldfarb NI, Moretti D, Cobb N, Howell JB, et al. Impact of chronic conditions on quality of life in patients with inflammatory bowel disease. Inflamm Bowel Dis 2006; 12(1): 47-52.
  7. Wells CW, Lewis S, Barton JR, Corbett S. Effects of changes in hemoglobin level on quality of life and cognitive function in inflammatory bowel disease patients. Inflamm Bowel Dis 2006; 12(2): 123-30.
  8. Liu K, Kaffes AJ. Iron deficiency anaemia: A review of diagnosis, investigation and management. Eur J Gastroenterol Hepatol 2012; 24(2): 109-16.
  9. Shah Y, Trivedi C, Patel D, Khan N. Management of iron deficiency anemia within one year of its diagnosis in a nationwide cohort of ulcerative colitis patients. Gastroenterology 2017; 152(5): S788.
  10. Ott C, Liebold A, Takses A, Strauch UG, Obermeier F. High prevalence but insufficient treatment of iron-deficiency anemia in patients with inflammatory bowel disease: Results of a population-based cohort. Gastroenterol Res Pract 2012; 2012: 595970.
  11. Gasche C, Lomer MC, Cavill I, Weiss G. Iron, anaemia, and inflammatory bowel diseases. Gut 2004; 53(8): 1190-7.
  12. Alves RA, Miszputen SJ, Figueiredo MS. Anemia in inflammatory bowel disease: Prevalence, differential diagnosis and association with clinical and laboratory variables. Sao Paulo Med J 2014; 132(3): 140-6.
  13. Kornbluth A, Sachar D, Salomon P. Crohn's disease. In: Sleisenger MN, Fordtran JS, editors. Gastrointestinal and liver diseases. 6th ed. Philadelphia, PA: Saunders; 1998. p. 1708-34.
  14. Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: Controversies, consensus, and implications. Gut 2006; 55(6): 749-53.
  15. Massey AC. Microcytic anemia. Differential diagnosis and management of iron deficiency anemia. Med Clin North Am 1992; 76(3): 549-66.
  16. Turati C, Tursini P, Franzini C, Pagliaro P, Berlusconi A, Cattozzo G. Saturazione della transferrina del siero e sovraccarico di ferro. Biochimica Clinical 1997; 21: 10-4.
  17. World Health Organization. Iron deficiency anaemia: Assessment, prevention and control: A guide for programme managers. Geneva, Switzerland: WHO; 2001.
  18. Gasche C, Berstad A, Befrits R, Beglinger C, Dignass A, Erichsen K, et al. Guidelines on the diagnosis and management of iron deficiency and anemia in inflammatory bowel diseases. Inflamm Bowel Dis 2007; 13(12): 1545-53.
  19. Kangaspunta M, Haapamaki J, Farkkila M, Arkkila P. Inflammatory bowel disease and anemia: intravenous iron treatment. Scand J Gastroenterol 2018; 53(4): 430-4.
  20. Arthur CK, Isbister JP. Iron deficiency. Misunderstood, misdiagnosed and mistreated. Drugs 1987; 33(2): 171-82.
  21. Gasche C, Reinisch W, Lochs H, Parsaei B, Bakos S, Wyatt J, et al. Anemia in Crohn's disease. Importance of inadequate erythropoietin production and iron deficiency. Dig Dis Sci 1994; 39(9): 1930-4.
  22. Schreiber S, Howaldt S, Schnoor M, Nikolaus S, Bauditz J, Gasche C, et al. Recombinant erythropoietin for the treatment of anemia in inflammatory bowel disease. N Engl J Med 1996; 334(10): 619-23.
  23. Wilson A, Reyes E, Ofman J. Prevalence and outcomes of anemia in inflammatory bowel disease: a systematic review of the literature. Am J Med 2004; 116 Suppl 7A: 44S-9S.
  24. Kulnigg S, Gasche C. Systematic review: Managing anaemia in Crohn's disease. Aliment Pharmacol Ther 2006; 24(11-12): 1507-23.
  25. Lakatos L, Pandur T, David G, Balogh Z, Kuronya P, Tollas A, et al. Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype: Results of a 25-year follow-up study. World J Gastroenterol 2003; 9(10): 2300-7.
  26. Bergamaschi G, Di SA, Albertini R, Ardizzone S, Biancheri P, Bonetti E, et al. Prevalence and pathogenesis of anemia in inflammatory bowel disease. Influence of anti-tumor necrosis factor-alpha treatment. Haematologica 2010; 95(2): 199-205.
  27. Ahluwalia N, Lammi-Keefe CJ, Bendel RB, Morse EE, Beard JL, Haley NR. Iron deficiency and anemia of chronic disease in elderly women: A discriminant-analysis approach for differentiation. Am J Clin Nutr 1995; 61(3): 590-6.
  28. Gomollon F, Gisbert JP. Anemia and digestive diseases: An update for the clinician. World J Gastroenterol 2009; 15(37): 4615-6.
Journal of Isfahan Medical School
Volume 36, Issue 490 - Serial Number 490
July and August 2018
Pages 884-889

  • Receive Date 25 June 2018
  • Accept Date 06 April 2022