Frequency, types, and treatment of anemia in Turkish patients with inflammatory bowel disease

Abstract

AIMTo specify the type and prevalence of anemia along with a treatment approach for inflammatory bowel disease (IBD).METHODSWe conducted a retrospective study on 465 patients who were diagnosed with IBD and followed up at our hospital from June 2015 to June 2016 [male: 254, female: 211; average age: 47 ± 14.4; Crohn’s disease (CD): 257, Ulcerative Colitis (UC): 208]. Epidemiological and clinical data, such as sex, age, age of diagnosis, type of IBD, disease extension, disease behavior and duration, treatments for IBD and anemia, and surgical history were obtained for each patient. Per World Health Organization guidelines, anemia was diagnosed for males if hemoglobin values were less than 13 g/dL and for females if hemoglobin values were less than 12 g/dL.RESULTSWe determined that 51.6% of the patients had anemia, which was more frequent in women then men (64% vs 41.3%, P < 0.001). Anemia frequency was higher in CD cases (57.6%) than in UC cases (44.2%) (P = 0.004). CD involvements were as follows: 48.2% in ileal involvement, 19% in colonic involvement, and 32.8% in ileocolonic involvement. Furthermore, 27.5% of UC patients had proctitis (E1) involvement, 41% of them had involvement in left colitis (E2), and 31.5% had pancolitis involvement. There was no significant relationship between anemia frequency and duration of disease (P = 0.55). Iron deficiency anemia (IDA) was the most common type of anemia in this cohort. Moreover, because anemia parameters have not been evaluated during follow-up of 15.3% of patients, the etiology of anemia has not been clarified. Fifty percent of patients with anemia received treatment. Twenty-three percent of IDA patients had oral iron intake and forty-one percent of IDA patients had parenteral iron treatment. Fifty-three percent of patients who were suffering from megaloblastic anemia received B12/folic acid treatment.CONCLUSIONWe found out that almost half of all IBD patients (51.6%) had anemia, the most frequent of which was IDA. Almost half of these patients received treatment. We should increase the treatment rate in our IBD patients that have anemia.

The burden and management of anemia in Greek patients with inflammatory bowel disease: a retrospective, multicenter, observational study

“…The present study showed that the frequency of anemia in Greek IBD patients followed at tertiary referral centers is 49.3% meaning that almost half of those patients experience anemia, which is similar to previous reports from other countries ( 2 , 13 – 16 ). Anemia was present more frequently in CD patients and in females which is also in accordance to other studies ( 13 , 15 , 17 ). It is of notice that there were few patients (6.5%) with anemia diagnosed more than one year before IBD diagnosis, whereas anemia was diagnosed at IBD diagnosis or less than one year before in 39.2% of the patients.…”

Methyl-donor supplementation prevents intestinal colonization by Adherent-Invasive E. coli in a mouse model of Crohn’s disease

“…Patients with Crohn's disease frequently present vitamin deficiencies such as vitamin B9 (Folate) and vitamin B12, as reported in many studies around the world [15][16][17][18][19] and recently confirmed in a review of meta-analyses by Piovani et al 40 . Folate deficiencies in patients were associated with greater disease activity in a Spanish cohort 19 .…”

“…The level of folate and other methyl-donor molecules intake through the diet were associated to the regulation of DNA methylation. Even more significantly, serum B12 and folate (B9) deficiencies have frequently been noticed in different cohorts of IBD patients [14][15][16][17][18][19][20] . Based on the known roles of these molecules in one-carbon metabolism, epigenetic modifications such as DNA methylation profiles and modified genes expression observed in CD patients could be the result, in part, of methyl-donor molecules deficiencies.…”

Anemija I Upalne Bolesti Crijeva

“…Nadalje, liječenje je ovisno o proširenosti i aktivnosti bolesti te prisutnosti intestinalnih i ekstraintestinalnih komplikacija. Najveći stupanj komorbiditeta s UBC ima anemija, koja negativno utječe na kvalitetu života, smanjuje radnu sposobnost i pridonosi smrtnosti oboljelih (11,12). Prema definiciji Svjetske zdravstvene organizacije, kod odraslih je muškaraca anemija prisutna ako je koncentracija hemoglobina manja od 130 g/L, a kod žena ako je koncentracija hemoglobina manja od 120 g/L.…”

“…Unsaturated Iron Binding Capacity) ili nezasićeni (slobodni) transferin za koji nije vezano željezo, transferina, saturacije transferina, feritina, eritrociti, hemoglobin, hematokrit, MCV ili prosječni volumen eritrocita, MCH ili prosječna količina hemoglobina u eritrocitu, MCHC ili prosječna koncentracija hemoglobina u eritocitima, retikulociti, te vrijednost CRP ili C-reaktivnog proteina. Dijagnoza sideropenične anemije postavljena je temeljem sljedećih kriterija: razina hemoglobina < 13 g/dL za muškarce, < 12 g/dL za žene, TfS< 20 %, razina feritina< 30 ng/mL, a zasićenost transferina (TSAT) < 16 %, MCH < 27 pg, MCV < 80 (12). Dijagnoza anemije kronične bolesti postavljena je temeljem sljedećih kriterija: razina hemoglobina < 13 g/dL, < 12 g/dL za žene, TfS< 20 %, CRP vrijednosti povišene uz TSAT < 16 % i feritin u intervalu 30 -100 ng/mL (12).…”