Abstract
Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1) determine the prevalence of anemia among patients with inflammatory bowel disease; 2) investigate whether routine laboratory markers are useful for diagnosing anemia; and 3) evaluate whether any association exists between anemia and clinical/laboratory variables. Cross-sectional at a federal university. 44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment) and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid) were investigated. Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6%) and ulcerative colitis (76.7%). Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index. Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.
Highlights
Inflammatory bowel diseases (IBD) comprise two main distinct clinical entities: Crohn’s disease (CD) and ulcerative colitis (UC)
The present study demonstrated that most patients with IBD had some type of hematological abnormality, with no difference in the distribution of these abnormalities between CD and UC (Table 2)
Anemia was observed in 20.5% of the patients with Crohn’s disease and in 23.6% with ulcerative colitis
Summary
Inflammatory bowel diseases (IBD) comprise two main distinct clinical entities: Crohn’s disease (CD) and ulcerative colitis (UC). The distal segments are affected and all viscera and the distal ileum may eventually be involved.[2,3]. Anemia has been considered to be an inevitable complication of CD and UC and its treatment has only recently become a specific objective for the management of such individuals.[4] Gasché et al.[5] showed that 33% of patients with CD had anemia [defined as hemoglobin (Hb) < 12 g/dl]. Another study reported a prevalence of anemia (Hb < 10 g/dl) of 26% in CD and of 37% in UC.[6]
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