THU0398 Unexplained iron deficiency is frequent in systemic sclerosis

Abstract

BackgroundPrevalance of iron deficiency (ID) in systemic sclerosis (SSc) is unclear and can occur related to several causes.ObjectivesThis cross sectional study aims to analyse association between ID and disease characteristics in SSc patients who does not have an overt cause for ID.MethodsWe identified 227 consecutive SSc patients who had iron laboratory studies (serum iron, total iron binding capacity and ferritin) with concurrent full blood count and serum C-reactive protein (CRP) measurement between May 2015 and November 2017. Exclusion criteria were as follows: not having serum CRP levels within 1 month of iron studies, chronic kidney disease (eGFR <60 ml/min), haemoglobinopathies, major surgery within one year, overt gastrointestinal (GI) or genitourinary blood loss, active GI cancer and vascular lesions of GI (GAVE, intestinal telengiectasia). Patients who have ferritin levels below cut-off values or were already on iron replacement were considered as iron deficient. To define iron deficient status, threshold levels of serum ferritin 30 ng/mL and 100 ng/mL were used to denote those with normal and high CRP levels (>5 mg/L) respectively. WHO classification system was used to determine the presence and severity of anaemia. Relationship between demographic and disease characteristics and serum iron status was analysed using Fisher’s exact and Mann-Whithey U test.Results178 patients (76.4% female) were eligible for final analysis. Clinical characteristics are reported in table 1. Median age and disease duration (interquartile range, IQR) were 54.6 (44.8–66.1) and 4.9 (2.1–4.8) years, respectively. ID was present in 43.2% of the patients and 41.6% of these patients was not anaemic. Iron deficient patients were more frequently female and had longer disease duration. Among female patients, ID was significantly more prevalent before the age of 50 (77.6% vs 0%, p<0.001).Abstract THU0398 – Table 1Comparison of demographics and disease characteristics between iron deficient and iron replete patientsConclusionsUnexplained iron deficiency is frequent in scleroderma patients and a significant number of these patients do not have frank anaemia. Female sex and longer disease duration is associated with iron deficiency. Increased frequency in young female patients can be related to menstrual blood loss and further study to evaluate this association is required.Disclosure of InterestNone declared

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