Management of anemia in inflammatory bowel disease: a challenge in everyday clinical practice

Tulewicz-Marti, Edyta; Moniuszko, Andrzej; Rydzewska, Grażyna

doi:10.5114/pg.2017.72096

Cited by 19 publications

(19 citation statements)

References 28 publications

(29 reference statements)

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“…We also reported that in this patients the female gender did not affect the incidence of venous thromboembolism. The management of inflammatory bowel disease is challenging because of its atypical pathophysiological mechanism, co-existing morbidities, and manifestations (49)(50)(51). Higher predisposition to venous thromboembolic events is one of the common co-morbidities of patients affected with inflammatory bowel disease (15,20,21) and is associated with poor prognostic outcome in terms of short-, long-term morbidity and mortality (22,52).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Venous Thromboembolism in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Zhang

Wang

2021

Front. Med.

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Background: Patients suffering from chronic inflammatory disorders, such as inflammatory bowel disorder, are at higher risk of developing thromboembolism. The chronic inflammatory nature of inflammatory bowel disease has been identified as a predominant reason for a state of Virchow's triad (i.e., endothelial dysfunction, stasis, and general hypercoagulability), eventually leading to the onset of venous thromboembolism. Recent studies show that certain factors, such as demographics, medication history, and history of surgical intervention may increase thromboembolism risk in patients with inflammatory bowel disease. However, to date, no study has attempted to evaluate the effect of different risk factors associated with the development of venous thromboembolism in inflammatory bowel disease patients.Objective: To evaluate the risk factors that can influence the incidence of venous thromboembolism in patients with inflammatory bowel disease.Methods: Academic literature was systematically searched based on the PRISMA guidelines across five databases: Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE. A random-effect meta-analysis was conducted to evaluate the hazard ratio for the risk factors (i.e., aging, gender, steroid therapy, surgery, and ulcerative colitis) that can influence the incidence of venous thromboembolism in patients with inflammatory bowel disease.Results: From a total of 963 studies, 18 eligible studies with 1,062,985 (44.59 ± 10.18 years) patients suffering from inflammatory bowel disease were included in the review. A meta-analysis revealed a higher risk of aging (Hazard's ratio: 2.19), steroids (1.87), surgery (1.48), and ulcerative colitis (2.06) on venous thromboembolism in patients with inflammatory bowel disease. We also found that the female gender (0.92) did not increase the incidence of venous thromboembolism in inflammatory bowel disease patients.Conclusion: The study provides preliminary evidence regarding high risks associated with ulcerative colitis, steroid consumption, and aging for the development of venous thromboembolism in patients with inflammatory bowel disease. The findings from this study may contribute to developing awareness among clinicians, better risk stratification and prevention of venous thromboembolic complications in patients with inflammatory bowel disease.

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Section: Discussionmentioning

confidence: 99%

Risk Factors of Venous Thromboembolism in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Zhang

Wang

2021

Front. Med.

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“…Iron dextran, also a high molecular weight-infused preparation, showed a similar reduction in cFGF23 in response to FCM with no change in iFGF23. Many other case reports have emerged in different patient populations receiving FCM that have exhibited hypophosphatemia due to significant elevations of iFGF23 (93)(94)(95)(96). These studies demonstrated that specific carboxyhydrate ligands reduce the ability to cleave iFGF23 into its inactivated fragments.…”

Section: B Iron Supplementationmentioning

confidence: 96%

Regulation of Fibroblast Growth Factor 23 by Iron, EPO, and HIF

Wheeler

Clinkenbeard

2019

Curr Mol Bio Rep

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Purpose of review: Fibroblast growth factor-23 (FGF23) is the key hormone produced in bone critical for phosphate homeostasis. Elevated serum phosphorus and 1,25dihydroxyvitaminD stimulates FGF23 production to promote renal phosphate excretion and decrease 1,25dihydroxyvitaminD synthesis. Thus completing the feedback loop and suppressing FGF23. Unexpectedly, studies of common and rare heritable disorders of phosphate handling identified links between iron and FGF23 demonstrating novel regulation outside the phosphate pathway. Recent Findings: Iron deficiency combined with an FGF23 cleavage mutation was found to induce the autosomal dominant hypophosphatemic rickets phenotype. Physiological responses to iron deficiency, such as erythropoietin production as well as hypoxia inducible factor activation, have been indicated in regulating FGF23. Additionally, specific iron formulations, used to treat iron deficiency, alter post-translational processing thereby shifting FGF23 protein secretion. Summary: Molecular and clinical studies revealed that iron deficiency, through several mechanisms, alters FGF23 at the transcriptional and post-translational level. This review will focus upon the novel discoveries elucidated between iron, its regulators, and their influence on FGF23 bioactivity.

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“…The second cause is anaemia of chronic disease, connected with negative impact of pro-inflammatory cytokines on erythropoiesis and shortened red blood cell survival. Vitamin B 12 and folic acid deficiencies, use of potentially myelotoxic drugs, and haemolysis may also contribute [8–11].…”

Section: Introductionmentioning

confidence: 99%

The prevalence, characteristics, and determinants of anaemia in newly diagnosed patients with inflammatory bowel disease

Woźniak¹,

Barańska²,

Małecka‐Panas³

et al. 2019

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Introduction Anaemia is the most common extraintestinal manifestation of inflammatory bowel disease, which has a negative impact on quality of life. Aim To determinate the prevalence, risk factors, and aetiology of anaemia in newly diagnosed patients with inflammatory bowel disease (IBD). Material and methods: We included 136 newly diagnosed patients with IBD. We analysed patient age, sex, laboratory tests, endoscopic and radiological examination, length of stay, and the course of hospitalisation. Results Anaemia at the time of IBD diagnosis was detected in 89 (65.4%) patients: 51 (57.3%) patients with ulcerative colitis vs. 38 (42.7%) patients with Crohn’s disease; p = 0.052. Female patients were more frequently anaemic than male patients (59.6% vs. 40.4%; p = 0.001). Anaemia was more often diagnosed in Crohn’s disease patients with ileocolonic involvement compared to other types of disease location (70.96% vs. 56.52%, respectively; p = 0.03). The prevalence of anaemia at the time of diagnosis for ulcerative colitis patients increased with disease extension: for extensive colitis anaemia was diagnosed in 64.71% compared to 35.29% in limited extension ( p < 0.05). Anaemic patients were hospitalised for significantly longer than patients with no anaemia (7.95 ±3.8 days vs. 5.88 ±2.7 days for Crohn’s disease; p = 0.02 and 9.02 ±5.0 days vs. 5.00 ±2.4 days for ulcerative colitis; p < 0.05). Conclusions Anaemia represents a frequent complication of IBD not only during the long-term course of the disease, but also at the moment of diagnosis. Anaemia is one of the factors extending the time of hospitalisation. Female sex and disease extent are strong determinant factors connected with anaemia.

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Management of anemia in inflammatory bowel disease: a challenge in everyday clinical practice

Cited by 19 publications

References 28 publications

Risk Factors of Venous Thromboembolism in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Risk Factors of Venous Thromboembolism in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Regulation of Fibroblast Growth Factor 23 by Iron, EPO, and HIF

The prevalence, characteristics, and determinants of anaemia in newly diagnosed patients with inflammatory bowel disease

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