The Epidemiology of Anemia in Pediatric Inflammatory Bowel Disease

Gerasimidis, Konstantinos; Barclay, Andrew; Papangelou, A.; Missiou, D.; Buchanan, Evan G.; Cardigan, Tracey; Tayler, Rachel; Russell, Richard K.; Edwards, Christine; McGrogan, Paraic

doi:10.1097/mib.0b013e31829ed855

Cited by 43 publications

(27 citation statements)

References 32 publications

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“…However, there was no such a significant difference in serum levels of vitamin B12, folic acid, ferritin and transferrin between IBD patients and healthy controls ( P > 0.05). These results indicate that the majority of IBD patients with anemia suffer from serum iron deficiency, consistent with previous reports 7 8 9 .…”

Section: Resultssupporting

confidence: 93%

“…Anemia in IBD patients may result from several causes such as lack of iron and other chronic diseases. Some patients are also caused by loss of vitamin B12 and folate, drug-associated side-effects (e.g., sulfasalazine, thiopurine) and several hematologic diseases 7 8 9 . Consistent with these findings, intravenous iron therapy has been performed in the treatment of anemia in patients with IBD and proven to be effective in the clinic 10 .…”

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confidence: 99%

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Divalent metal-ion transporter 1 is decreased in intestinal epithelial cells and contributes to the anemia in inflammatory bowel disease

Song

et al. 2015

Sci Rep

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Divalent metal-ion transporter 1 (DMT1) has been found to play an important role in the iron metabolism and hemogenesis. However, little is known about the potential role of DMT1 in the pathogenesis of anemia from patients with inflammatory bowel disease (IBD). Herein, we investigated expression of DMT1 in the intestinal mucosa by quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry, and found that DMT1 was significantly decreased in the inflamed mucosa of active IBD patients compared with that in those patients at remission stage and healthy controls. To further study the mechanism, we cultured HCT 116 cell line in vitro. Expression of DMT1 in HCT116 was demonstrated to be markedly decreased under stimulation with TNF for 24 and 48 h, while JNK inhibitor (JNK-IN-7) could significantly reverse the decrease. Interestingly, anti-TNF therapy successfully improved anemia in clinical responsive Crohn’s disease patients, and DMT1 was found to be markedly up-regulated in intestinal mucosa. Taken together, our studies demonstrate that decreased expression of DMT1 in intestinal mucosa leads to compromised absorption and transportation of iron and that blockade of TNF could rescue anemia and promote DMT1 expression in gut mucosa. This work provides a therapeutic approach in the management of anemia in IBD.

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Section: Resultssupporting

confidence: 93%

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confidence: 99%

Divalent metal-ion transporter 1 is decreased in intestinal epithelial cells and contributes to the anemia in inflammatory bowel disease

Song

et al. 2015

Sci Rep

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“…Previously reported data from smaller studies have shown similar prevalence of anemia with 70% in children and 42% in adolescents compared to 40% in adults [ 9 , 16 ].…”

Section: Discussionmentioning

confidence: 89%

“…We found in our study that almost two-thirds of pediatric IBD patients were anemic at the time of diagnosis. So far, there are very few studies that aim at anemia and iron deficiency in pediatric IBD, most of them in rather small cohorts and with short follow-up [ 8 , 9 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Anemia in Pediatric IBD Patients and Impact on Disease Severity: Results of the Pediatric IBD-Registry CEDATA-GPGE®

Laffolie

Laaß

Scholz

et al. 2017

Gastroenterology Research and Practice

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Aim To determine the prevalence of anemia and its association with disease severity in children and adolescents with IBD. Methods CEDATA-GPGE is a registry for pediatric patients with IBD in Germany and Austria from 90 specialized centers. As markers of disease severity, analysis included patient self-assessment on a Likert scale (1–5; 1 = very good) and physicians' general assessment (0 = no activity to 4 = severe disease) and the disease indices. Anemia was defined as hemoglobin concentration below the 3rd percentile. Results Prevalence of anemia was 65.2% in CD and 60.2% in UC. Anemic CD and UC patients showed significantly worse self-assessment than patients without anemia (average ± standard deviation; CD: 3.0 ± 0.9 versus 2.5 ± 0.9, p < 0.0001; UC: 2.9 ± 0.9 versus 2.3 ± 0.9, p < 0.0001). Accordingly, physicians' general assessment (PGA) was significantly worse in anemic than in nonanemic patients in CD (p < 0.0001) and UC (p < 0.0001). PCDAI in anemic CD, p < 0.0001, and PUCAI in anemic UC patients, p < 0.0001, were significantly higher than in nonanemic patients. 40.0% of anemic CD and 47.8% of anemic UC patients received iron during follow-up. Conclusion Almost 2/3 of pediatric IBD patients are anemic. Patients' self-assessment and disease severity as determined by PGA and activity indices are worse in anemic patients. Contrastingly, only a minority received iron therapy.

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Nutritional Management of Inflammatory Bowel Disease

Otley

Day

Zachos

2023

Pediatric Inflammatory Bowel Disease

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The Epidemiology of Anemia in Pediatric Inflammatory Bowel Disease

Abstract: Anemia is high at diagnosis and follow-up and should receive more attention from the clinical team; however, the focus should remain suppression of inflammatory process in active disease.

Cited by 43 publications

References 32 publications

Divalent metal-ion transporter 1 is decreased in intestinal epithelial cells and contributes to the anemia in inflammatory bowel disease

Divalent metal-ion transporter 1 is decreased in intestinal epithelial cells and contributes to the anemia in inflammatory bowel disease

Prevalence of Anemia in Pediatric IBD Patients and Impact on Disease Severity: Results of the Pediatric IBD-Registry CEDATA-GPGE®

Nutritional Management of Inflammatory Bowel Disease

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