Anemia in Inflammatory Bowel Disease Outpatients: Prevalence, Risk Factors, and Etiology

Abstract

Anemia is common in inflammatory bowel disease (IBD). However, epidemiological studies of nonwestern IBD populations are limited and may be confounded by demographic, socioeconomic, and disease-related influences. This study evaluated the prevalence, risk factors, and etiology of anemia in Brazilian outpatients with IBD. Methods. In this cross-sectional study, 100 Crohn's disease (CD) patients and 100 ulcerative colitis (UC) subjects were assessed. Anemia workup included complete blood count, ferritin, transferrin saturation, serum levels of folic acid and vitamin B12, and C-reactive protein (CRP) concentration. Results. The overall prevalence of anemia in IBD was 21%. There was no significant difference in the prevalence of anemia between CD subjects (24%) and UC (18%). Moderate disease activity (OR: 3.48, 95% CI, 1.95–9.64, P = 0.002) and elevated CRP levels (OR: 1.8, 95% CI, 1.04–3.11, P = 0.02) were independently associated with anemia. The most common etiologies of anemia found in both groups were iron deficiency anemia (IDA; 10% on CD and 6% on UC) followed by the anemia of chronic disease (ACD; 6% for both groups). Conclusions. In Brazilian IBD outpatients, anemia is highly concurrent condition. Disease moderate activity as well as increased CRP was strongly associated with comorbid anemia. IDA and/or ACD were the most common etiologies.

Prevalence of Anemia and Iron Deficiency in Romanian Patients with Inflammatory Bowel Disease: a Prospective Multicenter Study

“…This prevalence is slightly higher than that published recently in a meta-analysis by Filmann et al: 24% of 2,192 European patients with IBD had anemia [7]. Other studies show that up to 68% of inpatients with IBD had anemia [8,9]. The differences between the prevalence of anemia in IBD depend strongly on the studied population; for example, in the study of Bager et al, the study population consisted only of outpatients with IBD and anemia prevalence was found to be 19% [10].…”

Prevalence and prognostic impact of anemia and iron deficiency in patients hospitalized in an internal medicine ward: The PRO‐IRON study

“…Anemia has been associated with an individual prognostic factor for mortality in other studies . In our study, we report the association between anemia, ID, IDA, and IDWA and in‐hospital mortality.…”

Prevalence and screening for anaemia in mild to moderate Crohn's disease and ulcerative colitis in the United States, 2010–2014

“… 4 Patients with CD are more likely to be anaemic than those with UC. 18 20–23 There are several potential causes of anaemia in IBD including iron deficiency, anaemia of chronic disease, vitamin B 12 deficiency, folate deficiency and drug-induced anaemia. 7 8 16 18–21 Multiple types of anaemia may be present concurrently.…”