PB2043 UPPER AND LOWER GASTROINTESTINAL ENDOSCOPY FINDINGS IN PATIENTS WITH ISOLATED FERRITIN DEFICIENCY

Abstract

Background:Iron deficiency without anemia is the most common nutritional disorder in children. Iron balancing is provided by intestinal absorption and iron transfer mechanisms. The most common causes of anemia are chronic blood loss from the gastrointestinal tract (peptic ulcer, hemorrhoids, parasites), inadequate dietary intake, gynecological problems (menorrhagia), decreased gastrointestinal mucosal absorption (celiac disease), Helicobacter pylori (Hp) infection and autoimmune gastritis. In the literature, there are not many studies about iron deficiency without decreasing hemoglobin (Hg) levels in the early period of iron deficiency.Aims:In our study, we aimed to evaluate the lower and upper endoscopic findings of patients with normal Hg levels and low ferritin levels.Methods:A total of 2391 patients aged between 0‐18 years and had normal Hg levels were included into the study performing upper and lower gastrointestinal system (GIS) endoscopy by the pediatric gastroenterology‐hepatology department between 2009 and 2018. The patients were divided into two groups as Hb level was normal, ferritin level below 15 mg / dl (group 1; n = 549) and Hb level was normal, ferritin level was above 15 mg / dl (group 2; n = 1143). In group 1, upper GIS endoscopy was performed to 520 patients, lower GIS endoscopy to 56 patients. In Group 2, upper GI endoscopy was performed to 1095 patients and lower GI endoscopy to 120 patients. All endoscopy results of the patients were evaluated and compared.Results:The most common complaint was abdominal pain in both groups (63%, 67.4%, respectively). And the most common endoscopic findings in both groups were reflux esophagitis in the esophagus (9.6%, 9.1%, respectively, p>0.05), gastritis in the stomach (32.1%, 37.9%, respectively, p > 0.05). Hp gastritis was the second most common endoscopic finding in group 1. When the both groups were compared, there was a significant difference between group for Hp gastritis (24%, 27.6%, respectively, p = 0.002). In duodenum findings, celiac disease was higher in group 1 and there was a significant statistically between group for celiac disease (6%, 2.1%, respectively, p = 0.000). In colonoscopic examination, lymphoid nodular hyperplasia and polyp were higher in group 1 and there were statistically significant between groups (14.3%, 5%, and 10.7%, 3.3% respectively, p = 0.03, 0.04).Summary/Conclusion:In the literature, generally the studies are about anemia and upper GIS findings. In our study, the patients with decreased ferritin and normal Hg levels and undergoing upper and lower GIS endoscopy were investigated. The risk of Hp gastritis and celiac disease was found to be increased in patients with ferritin deficiency without anemia (group 1). In addition, lymphoid noduler hyperplasia and polyps were also caused ferritin deficiency.