Prevalence of Anemia and Iron Deficiency in Romanian Patients with Inflammatory Bowel Disease: a Prospective Multicenter Study
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Alexandru Lupu1, Mircea Diculescu1, Razvan Diaconescu2, Marcel Tantau3, Alina Tantau4, Ioana Visovan3, Cristian Gheorghe1, Cristina Lupei1, Liana Gheorghe1, Razvan Cerban1,
Roxana Vadan1, Adrian Goldis2
1) Fundeni Clinical Institute, Bucharest
2) Gastroenterology and Hepatology Hospital, Timisoara
3) Prof. Dr. O. Fodor Regional Institute of Gastroenterology and Hepatology, Cluj Napoca
4) 4th Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy
Background & Aims: Anemia is the most frequent systemic complication in inflammatory bowel diseases. It affects the quality of life and can interact with working capacity. Our objectives were to identify the prevalence of anemia, its main causes and its management in patients with inflammatory bowel disease from Romania.
Methods: We conducted a multicenter prospective study from March 2013 to August 2014. We enrolled 291 patients from three referral centers: 115 (39.52%) with Crohn's disease (CD) and 176 (60.48%) with ulcerative colitis (UC). We defined anemia according to the WHO criteria.
Results: Median age of the patients was 41 years and the median time period since diagnosis was 3 years (0.75-7). The median activity index for UC (UCAI) was 4 and the median CD activity index (CDAI) was 96. More patients with CD were on antiTNFα therapy (p < 0.01), corticosteroids (p =0.18) or azathioprine (p=0.05) and required surgery for their underlying disease at study enrollment (p < 0.01). Anemia was present in 31.27% of the patients, more often in those with CD (35.65%) than with UC (28.41%) (not statistically significant); 53.26% of the patients had iron deficiency while 4.12% had folic acid and 8.59% vitamin B12 deficiency; 9.62% of the patients had received anti-anemic therapy at inclusion in the study or in the last three months prior to study enrollment.
Conclusions: About one in three Romanian patients with inflammatory bowel disease has anemia, which is frequently associated with iron deficiency. About 30% of the patients with anemia are under therapy and the most frequent route for iron supplementation is the oral one. This might contribute to the high prevalence of iron deficiency and the low level of compliance.
Key words: anemia - iron deficiency - inflammatory bowel disease.