Portuguese Consensus on the Diagnosis, Prevention and Treatment of Anaemia in Inflammatory Bowel Disease

Magro, Fernando; Ramos, Jaime; Correia, Luís; Lago, Paula; Peixe, Paula; Ar, Gonçalves; Rodrigues, Ângela; Vieira, Catarina; Ferreira, Diva; J, Pereira Silva; Ma, Túlio; Salgueiro, Paulo

doi:10.20344/amp.6058

Cited by 4 publications

(5 citation statements)

References 104 publications

(143 reference statements)

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“…It has been suggested that anti-TNF therapy regulates erythropoiesis at various levels. However, some studies have shown that the prevalence of anemia was higher in patients treated with anti-TNF agents than those treated with other drugs ( e.g ., immunomodulators, corticosteroids, aminosalicylates)[ 48 ]. The higher prevalence reported in those studies is associated with the fact that these drugs (anti-TNF agents) are often used in patients with increased disease severity.…”

Section: Discussionmentioning

confidence: 99%

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

Bengi

Keyvan

DURMAZ

et al. 2018

WJG

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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.

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Section: Discussionmentioning

confidence: 99%

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

Bengi

Keyvan

DURMAZ

et al. 2018

WJG

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“…86 yet guidelines often lack agreement on test cut-off values for these parameters. 4 Serum ferritin levels are TABLE 1 Iron deficiency anemia has more guideline coverage than iron deficiency: summary of iron deficiency diagnostic measures, independent of anemia [68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85] Recommended iron deficiency threshold values independent of anemia although a CRP level of 5 mg L 21 is the most common threshold, 64 this is not recognized in most guidelines 68…”

Section: Diagnosis Of Iron Deficiency In Chronic Inflammatory Condimentioning

confidence: 99%

“…Iron deficiency anemia has more guideline coverage than iron deficiency: summary of iron deficiency diagnostic measures, independent of anemia[68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85] …”

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confidence: 99%

Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management

et al. 2017

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Iron deficiency, even in the absence of anemia, can be debilitating, and exacerbate any underlying chronic disease, leading to increased morbidity and mortality. Iron deficiency is frequently concomitant with chronic inflammatory disease; however, iron deficiency treatment is often overlooked, partially due to the heterogeneity among clinical practice guidelines. In the absence of consistent guidance across chronic heart failure, chronic kidney disease and inflammatory bowel disease, we provide practical recommendations for iron deficiency to treating physicians: definition, diagnosis, and disease‐specific diagnostic algorithms. These recommendations should facilitate appropriate diagnosis and treatment of iron deficiency to improve quality of life and clinical outcomes.

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“…The latest Portuguese [38] and European (ECCO) [39] consensus statements on the management of ID and anemia in IBD do not specifically address the pediatric population. However, ID is the most common nutritional deficit and IDA the most frequent form of anemia in this age group, and hence the opportunity to assess and monitor children's iron reserves and to investigate ID and IDA diagnosis in this age group should always be assured.…”

Section: Introductionmentioning

confidence: 99%

“…The goal of this consensus, elaborated by the Portuguese Society of Pediatric Gastroenterology and Nutrition (SPGNP) -Anemia-IBD Working Group, is to propose recommendations for the management of anemia in pediatric patients with IBD, based on ECCO [39] and on the Portuguese [38] consensus on anemia in IBD, specifically focusing on the features of ID and IDA in pediatric age.…”

Section: Introductionmentioning

confidence: 99%

Portuguese Consensus on Diagnosis, Treatment, and Management of Anemia in Pediatric Inflammatory Bowel Disease

Lopes

Azevedo

Cabral

et al. 2020

GE Port J Gastroenterol

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Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD), both in pediatric and in adult patients. Iron deficiency is the main cause of anemia in patients with IBD. Anemia is a clinically relevant comorbidity, with impact on patients' quality of life and it should be timely diagnosed and adequately treated. Currently, an active treatment approach is the recommended strategy, with evidence showing efficacy and safety of intravenous iron formulations. However, evidence in pediatric age remains scarce and no clinical recommendations exist for the diagnosis and treatment of this particular age group. The present document represents the first national consensus on the management of anemia in pediatric IBD and is therefore particularly relevant. The authors anticipate that the proposed recommendations will be useful in daily clinical practice for diagnosing and managing iron deficiency and iron-deficiency anemia in the pediatric population with IBD. ResumoA anemia é uma manifestação extra-digestiva frequente associada à doença inflamatória intestinal, tanto na população pediátrica como adulta, sendo a anemia por défice de ferro a sua forma mais frequente. Constitui uma comorbilidade clinicamente relevante, com repercussão na qualidade de vida. Deve ser atempadamente diagnosticada e adequadamente tratada. A estratégia terapêutica atualmente aceite preconiza uma atitude interventiva. Neste contexto, a evidência científica atual tem demonstrado a eficácia e segurança da utilização das formulações de ferro endovenoso. Contudo, em idade pediátrica a evidência ainda é insuficiente, não existindo orientações de abordagem diagnóstica ou terapêutica especificamente dirigidas a este grupo etário. Este é o primeiro consenso nacional sobre a abordagem da anemia na doença inflamatória intestinal pediátrica, revestindo-se por isso de particular relevância. Pretende-se que este documento tenha utilidade e aplicabilidade na prática clínica na avaliação e seguimento do défice de ferro e anemia por défice de ferro em doentes pediátricos com doença inflamatória intestinal.

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Portuguese Consensus on the Diagnosis, Prevention and Treatment of Anaemia in Inflammatory Bowel Disease

Cited by 4 publications

References 104 publications

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

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

Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management

Portuguese Consensus on Diagnosis, Treatment, and Management of Anemia in Pediatric Inflammatory Bowel Disease

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