Anemia in Newly Diagnosed Pediatric Patients with Inflammatory Bowel Disease

Rayna Shentova-Eneva,Penka Yaneva,Mila Baycheva,Denitza Kofinova,Petyo Hadzhiyski,Elena Lazarova

doi:10.3390/gastroent12040036

Rayna Shentova-Eneva, Penka Yaneva + Show 4 more

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https://doi.org/10.3390/gastroent12040036

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Abstract

Anemia is the most common extraintestinal manifestation and complication of inflammatory bowel disease (IBD). The aim of our study was to assess the prevalence of anemia in newly diagnosed pediatric patients with IBD and to analyze its association with disease type, extent, and severity. We retrospectively reviewed the medical records of all patients with IBD treated in our department in the period of November 2011 to November 2020. The final analysis included the records of 80 children with newly diagnosed IBD: 45 with ulcerative colitis (UC) and 35 with Crohn’s disease (CD). The prevalence of anemia was 60.0% in the UC patients and 77.1% in the CD patients. Of the UC patients with anemia, 37.1% had pancolitis, 18.5% extensive disease, 33.3% left-sided colitis and 11.1% ulcerative proctitis. Of the CD patients with anemia, 81.5% had ileocolonic disease, 11.1% colonic disease and 7.4% ileal disease. Anemia was less common in patients with mild disease than in patients with moderate–severe disease (22.2 vs. 77.8%, p < 0.001 in UC and 25.9% vs. 74.1%, p < 0.001 in CD). Our study confirmed anemia as a frequent problem in pediatric patients with IBD. Children with more extensive and more severe disease are at higher risk to develop anemia.

Highlights

The ratio of males to females was nearly equal for both Crohn’s disease (CD) and ulcerative colitis (UC)
To search for an association between the prevalence of anemia and disease extent, we found that of the UC patients with anemia 37.1% had pancolitis, 18.5% extensive disease, 33.3% left-sided colitis and 11.1% ulcerative proctitis (Figure 1a)
The prevalence of anemia that we demonstrated was less than in other studies reported, such as the 75% observed by Wiskin et al [17] and the 78% observed by Pels et al [18]

Summary

Introduction

Anemia is the most common extraintestinal manifestation and complication of inflammatory bowel disease (IBD) [1,2,3]. The main factors related to the development of anemia in IBD patients are blood loss from intestinal bleeding (acute and chronic), poor absorption of vitamins and minerals through the inflamed intestinal mucosa (such as vitamin B12, folic acid and iron) and chronic inflammation [4,5,6,7]. Rarer causes of anemia in IBD include the myelosuppressive effect of drugs, hemolysis and protein-losing enteropathy [7,8]. IBD-associated anemia results from a combination of different mechanisms, mainly iron deficiency anemia and anemia of chronic disease [5,7]

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