Abstract
Anemia is common in inflammatory bowel disease (IBD). However, epidemiological studies of nonwestern IBD populations are limited and may be confounded by demographic, socioeconomic, and disease-related influences. This study evaluated the prevalence, risk factors, and etiology of anemia in Brazilian outpatients with IBD. Methods. In this cross-sectional study, 100 Crohn's disease (CD) patients and 100 ulcerative colitis (UC) subjects were assessed. Anemia workup included complete blood count, ferritin, transferrin saturation, serum levels of folic acid and vitamin B12, and C-reactive protein (CRP) concentration. Results. The overall prevalence of anemia in IBD was 21%. There was no significant difference in the prevalence of anemia between CD subjects (24%) and UC (18%). Moderate disease activity (OR: 3.48, 95% CI, 1.95–9.64, P = 0.002) and elevated CRP levels (OR: 1.8, 95% CI, 1.04–3.11, P = 0.02) were independently associated with anemia. The most common etiologies of anemia found in both groups were iron deficiency anemia (IDA; 10% on CD and 6% on UC) followed by the anemia of chronic disease (ACD; 6% for both groups). Conclusions. In Brazilian IBD outpatients, anemia is highly concurrent condition. Disease moderate activity as well as increased CRP was strongly associated with comorbid anemia. IDA and/or ACD were the most common etiologies.
Highlights
Inflammatory bowel diseases (IBDs) are idiopathic multisystemic disorders that present with periods of relapses and remissions throughout their clinical course [1]
While ulcerative colitis (UC) is characterized by inflammation limited to the colonic mucosa, in Crohn’s disease (CD) transmural inflammation is observed that can affect any part of the gastrointestinal tract [2]
A total of 221 adult IBD outpatients were screened for the study
Summary
Inflammatory bowel diseases (IBDs) are idiopathic multisystemic disorders that present with periods of relapses and remissions throughout their clinical course [1]. While ulcerative colitis (UC) is characterized by inflammation limited to the colonic mucosa, in Crohn’s disease (CD) transmural inflammation is observed that can affect any part of the gastrointestinal tract [2]. In many patients, these conditions cause substantial personal cost, due to the unpredictable fluctuating symptoms, absenteeism at work, use of high-cost drugs, surgeries, or multidisciplinary care. Anemia is one of the most common extraintestinal manifestations (or complications) in IBD [3,4,5]. Anemia may occasionally both antecede the development of intestinal symptoms and be the key signal unmask IBD [3, 6]
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