Iron Absorption and Serum Ferritin in Chronic Inflammatory Bowel Disease

Bartels, Ulla; Pedersen, Niels Wisbech; Jarnum, S.

doi:10.3109/00365527809181777

Cited by 66 publications

(40 citation statements)

References 18 publications

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“…ID results from gastrointestinal blood loss, poor dietary intake and reduced iron bioavailability. Iron malabsorption is a contributing factor especially in CD affecting the small bowel [4]. Nearly 90% of children with IBD have ID with or without associated anemia [1].…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of parenteral iron in children with inflammatory bowel disease

Papadopoulos

Patel

Korologou-Linden³

et al. 2018

Brit J Clinical Pharma

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Objectives: Iron deficiency anemia (IDA) frequently complicates inflammatory bowel disease (IBD) in children and adults. Oral iron may exacerbate gastrointestinal symptoms and absorption may be insufficient in intestinal inflammation. Even where oral iron is successful, repletion of iron stores can be unacceptably slow. Intravenous (IV) iron compounds were in the past associated with serious adverse reactions and historically were considered a last resort in children. New generation preparations have a safer profile in adults although reluctance to use them in children may persist, where safety data is lacking. We investigate the safety and efficacy of ferric carboxymaltose (FCM) and iron sucrose (IS) in children. Methods:We retrospectively identified all children with IBD who received parenteral iron over a 38 month period in a single regional referral centre. Safety, tolerability and adverse events were established by case note review. Efficacy was assessed by change in hematinic indices pre-and posttreatment.Results: 47 children (18 male; median age 14yrs, range 3-17) received a total of 104 iron infusions. 44% (21) had Crohn's disease (CD); 56% (27) ulcerative colitis (UC). 40 received FC, eight IS and one both. Three children developed mild rash post infusion which resolved quickly with chlorphenamine. Mean increase in hemoglobin (Hb) was 2.5g/dl (0.3-5.8). Iron levels increased by a mean of 8.4 g/dl (1-25), transfer in saturation by 16.2% (2-47). Transfer in decreased by 0.84 g/dl (0.3-3.4). Conclusion:New generation parenteral iron preparations are safe, well tolerated and efficacious in children with IDA and IBD.What is known: Iron deficiency anemia (IDA) is a common complication of inflammatory bowel disease (IBD) and a significant contributor to morbidity.IDA should be actively treated in IBD.Parenteral iron is effective and relatively safe in adults. What is new:The intravenous iron preparations ferric carboxymaltose (FCM) and iron sucrose (IS) are effective treatments for IDA in children with IBD. The safety profiles of FCM and IS are favourable, and similar in children to that in adults.

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Section: Introductionmentioning

confidence: 99%

Safety and efficacy of parenteral iron in children with inflammatory bowel disease

Papadopoulos

Patel

Korologou-Linden³

et al. 2018

Brit J Clinical Pharma

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“…However, unlike with coeliac disease, Fe malabsorption is unlikely to occur in CD since Fe absorption occurs proximally while the disease predominates distally. Indeed, limited studies have suggested that Fe absorption is unaltered in patients with CD (Bartels et al 1978). However, sub-optimal dietary Fe intake has not been widely considered as a potential contributor to ID in CD, and yet deserves attention because food aversions and self-reported food intolerance are common in this patient group (Ballegaard et al 1997;Mishkin, 1997).…”

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confidence: 99%

Intake of dietary iron is low in patients with Crohn's disease: a case–control study

et al. 2004

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Patients with Crohn's disease (CD) often experience Fe deficiency (ID) and frequently alter their diet to relieve abdominal symptoms. The present study set out to assess whether patients with CD have dietary habits that lead to low Fe intakes and/or reduced bioavailable Fe compared with control subjects. Patients with asymptomatic CD were matched to controls (n91/group). Dietary intakes of Fe and contributions from different food groups were compared using a 7 d food diary. Promoters and inhibitors of non-haem Fe absorption were investigated and a recently published algorithm was applied to assess bioavailable Fe. Fewer patients than controls met the reference nutrient intake for Fe (32 % CD patientsv. 42 % controls). Overall, patients had significantly lower mean Fe intakes (by 2·3 mg/d) and Fe density (by 0·26 mg/MJ (1·1 mg/1000 kcal)) compared with controls (bothP<0·001). Differences were mainly due to a preference among CD patients for low-fibre non-Fe fortified cereals, particularly breakfast cereals. In particular, control subjects had higher Fe intakes than matched CD subjects for men (P<0·001) and women less than 50 years (P=0·03). Intakes of both ascorbic acid (P<0·001) and phytic acid (P<0·01), but not animal tissue (P=1·0), were lower in patients with CD, but these had no overall effect on the predicted percentage of bioavailable Fe. Thus total bioavailable Fe was reduced in patients with CD due to lower intakes (P<0·01). Dietary Fe intakes are low in CD patients, which may contribute to an increased risk of ID and anaemia. Changing dietary advice may compromise perceived symptoms of the disease so the need for Fe supplementation should be carefully considered.

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“…Pada semua usia kadar feritin akan rendah <12 µg/liter apabila terjadi defisiensi besi. Kadar feritin serum dapat meningkat pada penyakit infeksi akut maupun kronis, seperti pada inflammatory bowel disease, 4 infeksi virus atau bakteri, 5 keracunan endotoksin tanpa penumpukan zat besi dan keadaan hiperferitinemia tersebut dapat menggambarkan derajat kerusakan hepatoseluler serta demam rematik. 6 Peningkatan kadar serum feritin berhubungan juga dengan penyakit keganasan.…”

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Hubungan Kadar Feritin dengan Morbiditas pada Anak dengan Gizi Kurang

Lestari

Siregar

Nugroho

2016

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K ekurangan zatzat mikronutrien masih merupakan masalah utama di sebagian besar negara yang sedang berkembang. Kekurangan zat besi merupakan penyebab terbesar kekurangan zat mikronutrien di negara negara yang sedang berkembang. Food and Agriculture Organization (FAO) menyatakan lebih dari setengah anakanak di negara berkembang kekurangan zat besi. 1Kekurangan zat besi akan mengakibatkan beberapa kelainan. Salah satu kelainan yang disebabkan oleh karena kekurangan zat besi ini adalah gangguan pada fungsi imunitas tubuh.1 Hal ini dapat mempengaruhi imunitas tubuh baik imunitas humoral maupun imunitas seluler. Lebih lanjut kekurangan zat besi akan menyebabkan penurunan fungsi sel polimorfonuklear terutama neutrofil, penurunan jumlah dan fungsi limfosit T, penurunan aktivitas sel natural killer, serta penurunan aktivitas limfosit dan makrofag.

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Iron Absorption and Serum Ferritin in Chronic Inflammatory Bowel Disease

Cited by 66 publications

References 18 publications

Safety and efficacy of parenteral iron in children with inflammatory bowel disease

Safety and efficacy of parenteral iron in children with inflammatory bowel disease

Intake of dietary iron is low in patients with Crohn's disease: a case–control study

Hubungan Kadar Feritin dengan Morbiditas pada Anak dengan Gizi Kurang

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