Hidradenitis suppurativa is associated with iron deficiency anemia, anemia of chronic disease, and sickle cell anemia—A single-center retrospective cohort study

Parameswaran, Anupama; Garshick, Michael; Revankar, Rishab; Lu, Catherine P.; Chiu, Ernest S.; Sicco, Kristen I. Lo

doi:10.1016/j.ijwd.2021.07.008

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…This is consistent with studies in the literature, which report prevalence of anemia up to 40% in demographically diverse HS patient cohorts as compared to approximately 6% in the general population. 25,29,40 Studies demonstrating a positive association indicated prevalence of anemia in HS patient groups to be signi cantly higher than that in the general population. Considering both HS and anemia being more common in females of childbearing age, [5][6][7] Soliman et al, and Narla S., Silverberg J.I., adjusted for sex, age, and other potential confounders, and still found a statistically signi cant association.…”

Section: Discussionmentioning

confidence: 99%

“…The correlation of microcytic and normocytic subtypes is consistent with attributing anemia in HS patients to anemia of chronic in ammation. 28,29 Iron is involved in mechanisms integral to the pathogenesis of chronic in ammatory diseases. 46,47 In such cases, the peptide hormone hepcidin is increased, preventing the release of iron from ferritin stores, resulting in microcytic anemia.…”

Section: Discussionmentioning

confidence: 99%

“…Studies in the past have found statistically signi cant associations between HS and sickle cell anemia. 29 However, our list of included studies did not address this subtype.…”

Section: Discussionmentioning

confidence: 99%

“…27 Among the subtypes, anemia of chronic disease has been the most common subtype as being associated with chronic in ammatory diseases like HS. [28][29] Some studies, especially those attempting to analyze comorbidities of HS, have demonstrated a positive association between anemia and HS. [30][31][32][33][34] However, the association between the two conditions is not yet conclusive, as other studies have indicated lack of an association.…”

Section: Introductionmentioning

confidence: 99%

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Anemia in patients with hidradenitis suppurativa

et al. 2023

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IMPORTANCEHidradenitis suppurativa (HS) is associated with a number of physical and psychological comorbidities.Studies have suggested an association between HS and anemia; however, this association is not widely understood and may result in delayed diagnosis and treatment and possible increase in morbidity and mortality. OBJECTIVETo systematically review and perform a metanalysis regarding the association between HS and anemia, and to characterize the subtypes of anemia associated with HS. DATA SOURCESA search of the EMBASE, Medline, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials databases from the time of database inception to September 25, 2022, yielded 313 unique articles. STUDY SELECTIONAll observational studies and randomized controlled trials published in English that examined the odds ratio (OR) of anemia in patients with HS were screened by 2 independent reviewers. Case reports were excluded. Among 313 unique articles, 7 were deemed eligible. DATA EXTRACTION AND SYNTHESISThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines facilitated data extraction. The Newcastle-Ottawa Scale (NOS) was used to analyze risk of bias of included studies. In addition to OR and 95% con dence intervals, relevant data on patient demographics and anemia subtypes were also extracted. MAIN OUTCOMES AND MEASURESThe primary outcome was the OR of anemia in HS patients. This study also attempted to characterize anemia subtypes associated with HS. RESULTSIn total, 2 case-control and 5 cross-sectional studies featured a total of 11,693 patients. Among the studies, 4 of 7 demonstrated a statistically signi cant positive association between anemia and HS (ORs, 2.20 [1.42 to 3.41], 2.33 [1.99 to 2.73], 1.87 [1.02 to 3.44], and 1.50 [1.43 to 1.57]), with macrocytic and microcytic subtypes being most common. After adjusting for publication bias, meta-analysis with Page 3/15 random effects revealed HS to be associated with increased odds of anemia compared to non-HS groups (OR 1.59 [1.19, 2.11 ]) CONCLUSIONS AND RELEVANCEThere is a statistically signi cant positive association between HS and anemia, particularly for the aforementioned subtypes. Patients with HS should be screened for anemia. In case of lower hemoglobin concentration, the anemia of HS patients should be subdivided according to mean corpuscular volume of the red blood cells and further investigated depending on subtype. Key PointsQuestion What are the odds of anemia in patients with hidradenitis suppurativa (HS)? Findings This meta-analysis featured 7 total studies (2 case-control and 5 cross-sectional) comprising 11,693 participants. Meta-analysis revealed HS to be associated with increased odds of anemia compared to non-HS groups. Three studies found an association with microcytic anemia and two with macrocytic anemia.Meaning Patients with HS should be screened for anemia. In case of lower hemoglobin concentration, the anemia of HS patients should be subdivided according to mean corpuscular volume of ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Studies in the past have found statistically signi cant associations between HS and sickle cell anemia. 29 However, our list of included studies did not address this subtype.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anemia in patients with hidradenitis suppurativa

et al. 2023

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“…Hidradenitis suppurativa (HS) is an inflammatory skin disorder that is characterized by nodules, abscesses, and sinus tracts . Substantial inflammatory burden, anemia, and leukocytosis have been frequently reported in patients with HS . We previously reported that anemia, leukocytosis, or thrombocytosis improved after immunomodulatory therapy in a small cohort of patients with HS .…”

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confidence: 99%

Hematologic Abnormalities in Patients With Hidradenitis Suppurativa Receiving Adalimumab

Gunter,

Holcomb,

Lam

et al. 2024

JAMA Dermatol

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Complex hidradenitis suppurativa on a background of long‐standing Crohn's disease requiring radical pelvic and perineal reconstruction: A case report

Forder,

Nistor,

Mykula

et al. 2024

Clinical Case Reports

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Key Clinical MessageA surgical MDT approach to high‐complexity surgeries can allow maximal resection in order to achieve disease control and excellent functional outcomes, as demonstrated here for a case of hidradenitis suppurativa in a patient with Crohn's disease.AbstractHidradenitis suppurativa is an autoimmune disease characterized by abscess and fistula formation with purulent discharge in intertriginous zones, and is associated with inflammatory bowel disease. We present the case of a patient with severe ongoing hidradenitis suppurativa causing osteomyelitis and affecting the perineum, on a background of Crohn's disease previously treated with panprotocolectomy and permanent ileostomy. The hidradenitis suppurativa was having a severe impact on the patient's quality of life, and she had failed to respond to conservative management. The patient opted for a radical two‐step procedure: first her coccyx and sacrum were removed. The second step was a radical bilateral anterior vulvectomy and posterior vaginectomy, with preservation of the uterine body and cervix. An anterolateral thigh flap was used to reconstruct the perineum. This complex procedure required the expertise of multiple surgical specialties, including plastic, general, spinal, and gynecological oncology surgeons to achieve maximal disease resection, minimizing the risk of recurrence.

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Hidradenitis suppurativa is associated with iron deficiency anemia, anemia of chronic disease, and sickle cell anemia—A single-center retrospective cohort study

Cited by 9 publications

References 5 publications

Anemia in patients with hidradenitis suppurativa

Anemia in patients with hidradenitis suppurativa

Hematologic Abnormalities in Patients With Hidradenitis Suppurativa Receiving Adalimumab

Complex hidradenitis suppurativa on a background of long‐standing Crohn's disease requiring radical pelvic and perineal reconstruction: A case report

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