Systematic review: managing anaemia in Crohn's disease

Kulnigg, Stefanie; Gasché, Christoph

doi:10.1111/j.1365-2036.2006.03146.x

Cited by 291 publications

(307 citation statements)

References 138 publications

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“…The anemia common to patients with IBD is mainly due to iron deficiency from blood loss, either alone or in combination, and suppression of erythropoiesis and iron binding (17,18) due to proinflammatory cytokine activity. There has been support for aggressively treating anemia in IBD using iron therapy for those who are iron deficient and using erythropoietin for subjects with impaired red blood cell production (15,(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

“…Expert reviews have suggested the use primarily of serum ferritin (with or without transferrin saturation) (18)(19)(20), with some indicating that the addition of sTfR could enhance the ascertainment of iron deficiency in IBD, considering that serum ferritin is an acute phase reactant and thus can be difficult to interpret in the presence of inflammation (19,20). Soluble transferrin receptor (sTfR) is thought to be more sensitive than ferritin at detecting iron deficiency, although the incremental utility of this index continues to be debated (24,25).…”

Section: Introductionmentioning

confidence: 99%

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Is Iron Deficiency in the Absence of Anemia Associated With Fatigue in Inflammatory Bowel Disease?

Goldenberg

Graff

Clara

et al. 2013

American Journal of Gastroenterology

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is Iron Deficiency in the Absence of Anemia Associated With Fatigue in Inflammatory Bowel Disease?

Goldenberg

Graff

Clara

et al. 2013

American Journal of Gastroenterology

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“…As absorption is erratic and incomplete, in our practices, we avoid oral formulations after bariatric surgery where absorption is marginal, in inflammatory bowel disease where oral iron can worsen symptoms [24,25], and in patients with conditions associated with a rate of blood loss that exceeds the ability of the absorptive process to keep up with the losses, such as heavy uterine bleeding and hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu).…”

mentioning

confidence: 99%

How we diagnose and treat iron deficiency anemia

2015

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It is estimated that one‐third of the world's population is anemic, the majority being due to iron deficiency (ID). In adults, ID is associated with fatigue in the absence of anemia, restless legs syndrome, pica and, in neonates, delayed growth and development. In adolescents, ID is associated with decrements in learning and behavioral abnormalities. In the absence of a clear cause, search for a source of bleeding is indicated. No single test is diagnostic of ID unless the serum ferritin is low or the percent transferrin saturation is low with an elevated total iron binding capacity. Oral iron is considered front line therapy except for conditions such as gastric bypass, heavy uterine bleeding, inflammatory bowel disease, and hereditary hemorrhagic telangiectasia. Oral iron has many unpleasant side effects, resulting in low patient adherence. For patients intolerant of, or unresponsive to, oral iron, intravenous (IV) administration is the preferred route. While early formulations were associated with a high incidence of serious adverse events (SAEs), newer formulations are much safer with SAEs occurring very infrequently. Full replacement doses can be administered in a matter of minutes to a few hours. Nevertheless, there remains a reluctance to use IV iron due to a misunderstanding of the safety of the available formulations. IV iron is safe and effective in all clinical circumstances including pregnancy. The preponderance of published evidence suggests IV iron therapy is underutilized and we believe that IV iron should be moved forward in the treatment of ID and iron deficiency anemia (IDA). Am. J. Hematol. 91:31–38, 2016. © 2015 Wiley Periodicals, Inc.

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“…Inadequate monitoring and treatment leads to a worse quality of life [88,89] and increased morbidity and hospitalization [90][91][92] . Repeated loss of blood, and to a lesser extent malabsorption of iron are the main causes of iron deficiency in IBD [86] .…”

Section: Ibdmentioning

confidence: 99%

Use of agents stimulating erythropoiesis in digestive diseases

López¹,

Sicilia²,

García³

2009

WJG

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Anemia is the most common complication of inflammatory bowel disease (IBD). Control and inadequate treatment leads to a worse quality of life and increased morbidity and hospitalization. Blood loss, and to a lesser extent, malabsorption of iron are the main causes of iron deficiency in IBD. There is also a variable component of anemia related to chronic inflammation. The anemia of chronic renal failure has been treated for many years with recombinant human erythropoietin (rHuEPO), which significantly improves quality of life and survival. Subsequently, rHuEPO has been used progressively in other conditions that occur with anemia of chronic processes such as cancer, rheumatoid arthritis or IBD, and anemia associated with the treatment of hepatitis C virus. Erythropoietic agents complete the range of available therapeutic options for treatment of anemia associated with IBD, which begins by treating the basis of the inflammatory disease, along with intravenous iron therapy as first choice. In cases of resistance to treatment with iron, combined therapy with erythropoietic agents aims to achieve near-normal levels of hemoglobin/hematocrit (11-12 g/dL). New formulations of intravenous iron (iron carboxymaltose) and the new generation of erythropoietic agents (darbepoetin and continuous erythropoietin receptor activator) will allow better dosing with the same efficacy and safety.

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Systematic review: managing anaemia in Crohn's disease

Abstract: SUMMARY BackgroundAnaemia is a serious complication of Crohn's disease that triggers hospitalization and, if not interfered with, may lead to death.

Cited by 291 publications

References 138 publications

Is Iron Deficiency in the Absence of Anemia Associated With Fatigue in Inflammatory Bowel Disease?

Is Iron Deficiency in the Absence of Anemia Associated With Fatigue in Inflammatory Bowel Disease?

How we diagnose and treat iron deficiency anemia

Use of agents stimulating erythropoiesis in digestive diseases

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