Doença Celíaca, Gastrite Atrófica Autoimune e Helicobacter pylori na Anemia Refratária ao Ferro Oral

Abstract

CELIAC DISEASE, AUTOIMMUNE ATROPHIC GASTRITIS AND HELICOBACTER PYLORI IN ORAL IRON THERAPY RESISTANCE ANEMIA Objectives: Identify the number of celiac disease (CD), autoimmune atrophic gastritis (AAG) and the Helicobacter pylori (Hp) infection in patients with iron-refractory iron deficiency anemia (RIA). Type of study: Observational, retrospective, longitudinal. Location: Hospital center hematology unit in the north region of Portugal. Population: All first hematology consultations of patients with RIA between 2011 and 2016. Methods: Collection of data using the electronic clinical file (socio-demographic, origin of the consultation request and diagnostic tests data). Microsoft Excel 2016® was used to analyze and process the data. Results: We identified 48 cases of iron-refractory iron deficiency anemia (9.3% of 518 patients with iron deficiency anemia). A complete screening for CD, AAG and the infection by Hp was made for 24 patients. A partial screening (only for one or two of these diseases) was made for 19 patients. In the 43 cases that at least one of the screenings were made, the prevalence of CD was about 4.7%, the prevalence of AAG was 14% and the infection by Hp was 30.2%. We couldn't evaluate the Hp eradication because it wasn't confirmed in six of 13 cases identified with this pathology. In the other seven cases, Hp eradication solved anemia in only one patient. Conclusion: We identified a high percentage of patients with iron-refractory iron deficiency anemia that suffer from AAG and infection by Hp, as is referred to in international studies. These findings reinforce the role of these diseases in iron-refractory iron deficiency anemia in the Portuguese population. This work reinforces the need to screen for CD, AAG and Hp infection in iron-refractory iron deficiency anemia.

Casos de Anemia notificados em pacientes pediátricos no norte do Brasil

“…In Table III, the findings were hypochromic microcytic anemia, this type of anemia is characterized by the size of erythrocytes (MCV<80fl), low concentrations of hemoglobin (CHCM<32%) with high levels of RDW and normally, this occurs through iron deficiency in the diet, as well as causes of hereditary anemia 21 . Therefore, it is considerable to obtain knowledge about anthropology and migratory movements of the population, as well as the contributions that public health and public health policies 16,18 .…”

“…In several studies, it is stated that children are more exposed to anemia, which is explained by the growth in this age group 7,12,20,21 , the high prevalence of early weaning in the country, the lack of foods rich in iron in the child's diet and the higher prevalence of diseases such as diarrhea and respiratory infections in the first years of life 19,21 . Amarante et al 17 , saw that 17.8% of patients aged 11 to 20 years old had hypochromic microcytic anemia, it is known that the main nutritional problems of adolescents are micronutrient deficiencies, in particular the deficiency of iron and, depending on the context, malnutrition or obesity and comorbidities 19 .…”