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For: Annibale B, Capurso G, Chistolini A, D'Ambra G, DiGiulio E, Monarca B, DelleFave G. Gastrointestinal causes of refractory iron deficiency anemia in patients without gastrointestinal symptoms. Am J Med 2001;111:439-445. [PMID: 11690568 DOI: 10.1016/s0002-9343(01)00883-x] [Citation(s) in RCA: 135] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]

For:	Annibale B, Capurso G, Chistolini A, D'Ambra G, DiGiulio E, Monarca B, DelleFave G. Gastrointestinal causes of refractory iron deficiency anemia in patients without gastrointestinal symptoms. Am J Med 2001;111:439-445. [PMID: 11690568 DOI: 10.1016/s0002-9343(01)00883-x] [Citation(s) in RCA: 135] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]

Number

Cited by Other Article(s)

Arab NS, Alkhatabi RK, Alhalafi AF, Beyari MB, Alahmadi RA, Almazro AA. Transanal Resection of a Prolapsed Rectal Lipoma: A Report of a Rare Case. Cureus 2025;17:e78247. [PMID: 39885939 PMCID: PMC11781804 DOI: 10.7759/cureus.78247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2025] [Indexed: 02/01/2025] Open

Bianchi PI, Aronico N, Santacroce G, Broglio G, Lenti MV, Di Sabatino A. Nutritional Consequences of Celiac Disease and Gluten-Free Diet. GASTROENTEROLOGY INSIGHTS 2024;15:878-894. [DOI: 10.3390/gastroent15040061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2025] Open

Choudhary R, Khan MA, Dosi R, Choudhari S, Pawar D, Shahavi V, Sharma A. Fixed dose combination of aspirin and pantoprazole: Results of a multicenter, comparative, randomized, double-blind, double dummy, phase III study in Indian patients. Indian Heart J 2024;76:280-285. [PMID: 39009075 PMCID: PMC11451355 DOI: 10.1016/j.ihj.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/05/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024] Open

Vavallo M, Cingolani S, Cozza G, Schiavone FP, Dottori L, Palumbo C, Lahner E. Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective. Int J Mol Sci 2024;25:6818. [PMID: 38999928 PMCID: PMC11241626 DOI: 10.3390/ijms25136818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 07/14/2024] Open

Taylor L, McCaddon A, Wolffenbuttel BHR. Creating a Framework for Treating Autoimmune Gastritis-The Case for Replacing Lost Acid. Nutrients 2024;16:662. [PMID: 38474790 DOI: 10.3390/nu16050662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open

Plotnikova EY. Autoimmune gastritis. MEDITSINSKIY SOVET = MEDICAL COUNCIL 2024:157-167. [DOI: 10.21518/ms2023-467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]

Kaibysheva V, Tykhonov S, Kashin S, Kuvaev R, Kraynova E, Baculina N, Fedorov E, Drapkina O. Algorithm of autoimmune gastritis diagnosis and treatment. RUSSIAN JOURNAL OF PREVENTIVE MEDICINE 2024;27:101. [DOI: 10.17116/profmed202427091101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]

Dottori L, Corleone Tsar'kov D, Dilaghi E, Pivetta G, Scalamonti S, Ligato I, Esposito G, Annibale B, Lahner E. Efficacy and Safety of Intravenous Ferric Carboxymaltose Treatment of Iron Deficiency Anaemia in Patients with Corpus Atrophic Gastritis: A Retrospective Study. Nutrients 2023;15:4199. [PMID: 37836482 PMCID: PMC10574262 DOI: 10.3390/nu15194199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open

Terao S, Suzuki S, Kushima R. Histopathologic diagnosis of ultra-early autoimmune gastritis: A case report. Clin Case Rep 2023;11:e7458. [PMID: 37361662 PMCID: PMC10290196 DOI: 10.1002/ccr3.7458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/30/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open

Singh A, Mishra R, Ranjan R. Gastrointestinal Lesions and Its Associated Factors in Adult Males With Iron Deficiency Anaemia: A Cross-Sectional Study From Tertiary Care Centre of North India. Cureus 2022;14:e26905. [PMID: 35983390 PMCID: PMC9376560 DOI: 10.7759/cureus.26905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 11/14/2022] Open

Pivetta G, Dilaghi E, Lahner E. No Danger for Medical Interest and Awareness towards Celiac Disease. Reply to Greenaway et al. Why Is There Medical Inertia and Nihilism to Celiac Disease? Comment on "Pivetta et al. In Elderly Anemic Patients without Endoscopic Signs of Bleeding Are Duodenal Biopsies Always Necessary to Rule Out Celiac Disease? Diagnostics 2022, 12, 678". Diagnostics (Basel) 2022;12:1511. [PMID: 35885417 PMCID: PMC9319639 DOI: 10.3390/diagnostics12071511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/17/2022] [Indexed: 11/21/2022] Open

Mittal A, Gupta S, Afridi F, Dimitrey A, Ahlawat S. Do Socio-Demographics Play a Role in the Prevalence of Red Flags and Pursuant Colonoscopies in Patients With Irritable Bowel Syndrome? Cureus 2022;14:e25137. [PMID: 35747043 PMCID: PMC9206447 DOI: 10.7759/cureus.25137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 11/18/2022] Open

Abstract

Background

Irritable bowel syndrome (IBS) is a “brain-gut disorder” that lacks laboratory, radiologic, or physical exam findings. Colonoscopies are not routinely performed unless “red flag” symptoms, such as bleeding or abnormal weight loss, are present. Socio-demographics have been implicated as sources of potential disparities in appropriate care.

Aims

We hypothesize that the incidence of red flag symptoms and pursuant colonoscopies differ by socio-demographic status in patients with IBS.

Methods

Patients diagnosed with IBS were extracted from the National Inpatient Sample 2001-2013 using the International Classification of Diseases, Ninth Revision (ICD-9) codes. Gastrointestinal bleed, blood in stool, weight loss, and anemia were pooled into red flag symptoms. Colonoscopies during the admission were identified using ICD-9 procedural codes. Chi-square analysis and binomial logistic regression were used to evaluate potential disparities with α<0.01.

Results

Patients with Medicaid or Medicare or those without insurance had higher odds of presenting with red flag symptoms compared to those with private insurance. Medicaid patients and uninsured patients had higher odds of undergoing colonoscopies. All patients that were not Caucasian had higher odds of presenting with red flags and subsequently undergoing colonoscopies. Older patients had higher odds of presenting with concerning red flag symptoms but lower odds of undergoing colonoscopies.

Conclusions

The incidence of red flag symptoms and performance of colonoscopies differed by socio-demographics in patients with IBS. Patients with non-private or those without insurance were more likely to have red flags and undergo a colonoscopy. Age and race also increased rates of red flag symptoms while having a mixed effect on pursuant colonoscopies. This may represent discrepancies in healthcare utilization in a vulnerable population.

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Esposito G, Dottori L, Pivetta G, Ligato I, Dilaghi E, Lahner E. Pernicious Anemia: The Hematological Presentation of a Multifaceted Disorder Caused by Cobalamin Deficiency. Nutrients 2022;14:nu14081672. [PMID: 35458234 PMCID: PMC9030741 DOI: 10.3390/nu14081672] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/08/2022] [Accepted: 04/14/2022] [Indexed: 02/04/2023] Open

Gomez HM, Pillar AL, Brown AC, Kim RY, Ali MK, Essilfie AT, Vanders RL, Frazer DM, Anderson GJ, Hansbro PM, Collison AM, Jensen ME, Murphy VE, Johnstone DM, Reid D, Milward EA, Donovan C, Horvat JC. Investigating the Links between Lower Iron Status in Pregnancy and Respiratory Disease in Offspring Using Murine Models. Nutrients 2021;13:nu13124461. [PMID: 34960012 PMCID: PMC8708709 DOI: 10.3390/nu13124461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open

Affiliation(s)

Henry M. Gomez School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
Amber L. Pillar School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
Alexandra C. Brown School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
Richard Y. Kim School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.) Faculty of Science, School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
Md Khadem Ali School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
Ama-Tawiah Essilfie QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
Rebecca L. Vanders School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
David M. Frazer QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.) School of Biomedical Sciences, The University of Queensland, St Lucia, QLD 4067, Australia
Gregory J. Anderson QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.) School of Chemistry and Molecular Bioscience, The University of Queensland, St Lucia, QLD 4067, Australia
Philip M. Hansbro School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.) Centre for Inflammation, School of Life Sciences, Faculty of Science, Centenary Institute and University of Technology Sydney, Sydney, NSW 2007, Australia
Adam M. Collison School of Medicine and Public Health, College of Health, Medicine and Wellbeing, and Priority Research Centre for GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (A.M.C.); (M.E.J.); (V.E.M.)
Megan E. Jensen School of Medicine and Public Health, College of Health, Medicine and Wellbeing, and Priority Research Centre for GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (A.M.C.); (M.E.J.); (V.E.M.)
Vanessa E. Murphy School of Medicine and Public Health, College of Health, Medicine and Wellbeing, and Priority Research Centre for GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (A.M.C.); (M.E.J.); (V.E.M.)
Daniel M. Johnstone School of Medical Sciences, University of Sydney, Camperdown, NSW 2050, Australia;
David Reid QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
Elizabeth A. Milward School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
Chantal Donovan School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.) Faculty of Science, School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
Jay C. Horvat School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.) Correspondence: ; Tel.: +612-4042-0220

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Chibulcutean O, Gabor MR, Frandes SI, Mocan S, Dumitrascu DI, Negovan A. Demographic, hematologic, and endoscopic differences between predominant corporeal and antral atrophic gastritis: A STROBE-Compliant study. Medicine (Baltimore) 2021;100:e28062. [PMID: 34889251 PMCID: PMC8663852 DOI: 10.1097/md.0000000000028062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 05/29/2021] [Accepted: 11/11/2021] [Indexed: 01/05/2023] Open

Abstract

ABSTRACT

The study aimed to assess demographic, clinical, and endoscopic parameters in patients with predominant corporeal atrophic gastritis (CAG) and enterochromaffin-like cell hyperplasia suggestive for autoimmune etiology in comparison with patients presenting Helicobacter pylori atrophic gastritis limited to the gastric antrum (AAG).Demographical, clinical, and pathological data of consecutive patients who underwent an upper digestive endoscopy for bleeding screening risk, symptoms, or anemia in a single endoscopy unit were retrieved. The final study group included 63 patients with CAG and enterochromaffin-like cell hyperplasia on histology and a control group of 142 patients with AAG.Female patients were predominant in the group with CAG versus AAG (69.8% vs 46.4%, P = .002). Microcytic anemia (P < .001), but not macrocytic anemia (P = .14) was associated with CAG, the mean corpuscular volume of erythrocyte (MCV) (82.5 vs 86.5 fl, P = .01), the mean value of serum iron (11.8 vs 14.3 μmol/L, P = .02), and hemoglobin level (11.0 vs 12.7 g/dL P < .01) being significantly lower in patients with CAG versus AAG. Upper digestive endoscopies with no visible mucosal lesions (P = .01) were also more frequent in the patients with CAG, but there were not differences regarding digestive symptoms between groups. The linear regression models revealed that the low hemoglobin (P < .001) and low MCV (P = .03) are the independent variables that can predict CAG on histology, but not the serum iron level (P = .77)Consecutive patients investigated on endoscopy with CAG in comparison with those having AAG are more frequent female, they have microcytic anemia, and no mucosal lesions on endoscopy. The decreased hemoglobin level and low MCV, rather than the serum iron level are predictors for CAG versus AAG on histology in endoscopic population.

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Iron Deficiency in Celiac Disease: Prevalence, Health Impact, and Clinical Management. Nutrients 2021;13:nu13103437. [PMID: 34684433 PMCID: PMC8537360 DOI: 10.3390/nu13103437] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/13/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023] Open

ŞENKAYA A, ÇELİK F, ÖZÜTEMİZ Ö. Endoscopic findings in the older patients with iron-deficiency anemia. EGE TIP DERGISI 2021. [DOI: 10.19161/etd.915674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open

Rodriguez-Alonso L, Rodriguez-Moranta F, Ruiz-Cerulla A, Arajol C, Serra K, Gilabert P, Ibañez-Sanz G, Camps B, Guardiola J. The use of faecal immunochemical testing in the decision-making process for the endoscopic investigation of iron deficiency anaemia. Clin Chem Lab Med 2021;58:232-239. [PMID: 31785194 DOI: 10.1515/cclm-2019-0203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/17/2019] [Indexed: 12/15/2022]

Dietrich CG, Hübner D, Heise JW. Paraesophageal hernia and iron deficiency anemia: Mechanisms, diagnostics and therapy. World J Gastrointest Surg 2021;13:222-230. [PMID: 33796212 PMCID: PMC7993000 DOI: 10.4240/wjgs.v13.i3.222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/23/2021] [Accepted: 03/10/2021] [Indexed: 02/06/2023] Open

Carabotti M, Annibale B, Lahner E. Common Pitfalls in the Management of Patients with Micronutrient Deficiency: Keep in Mind the Stomach. Nutrients 2021;13:208. [PMID: 33450823 PMCID: PMC7828248 DOI: 10.3390/nu13010208] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 12/31/2020] [Accepted: 01/08/2021] [Indexed: 02/05/2023] Open

Rockey DC, Altayar O, Falck-Ytter Y, Kalmaz D. AGA Technical Review on Gastrointestinal Evaluation of Iron Deficiency Anemia. Gastroenterology 2020;159:1097-1119. [PMID: 32828801 PMCID: PMC10824166 DOI: 10.1053/j.gastro.2020.06.045] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]

Odhaib SA, Mohammed MJ, Hammadi S. Efficacy of Gastrointestinal Endoscopy in 398 Patients With Iron Deficiency Anemia Who Lack Gastrointestinal Symptoms: Basrah Experience. Cureus 2020;12:e9206. [PMID: 32821560 PMCID: PMC7430437 DOI: 10.7759/cureus.9206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open

Abstract

Introduction

The diagnosis of iron deficiency anemia (IDA) relies heavily on symptom presentation, and patients lacking typical gastrointestinal (GI) symptoms represent a diagnostic challenge. IDA may be the initial manifestation of underlying pathology. This study sought to evaluate the effectiveness of different GI endoscopic studies in patients with IDA who lack GI symptoms.

Methods

We conducted an observational, multicenter retrospective analysis of 398 asymptomatic IDA patients admitted for GI endoscopic diagnosis from 2006 to 2016. Baseline measurements included hemoglobin, serum ferritin, mean corpuscular volume, serum iron, total iron-binding capacity, and transferrin saturation. We analyzed demographic characteristics, duration of hospital stay, the degree of severity of anemia, and endoscopic findings.

Results

The mean age of the study population was 52±9 years (range, 23 to 85 years), and 53% were men. Most patients were older than 45 years (n=353, 89%) with mild to moderate IDA. Patients underwent esophagogastroduodenoscopy (EGD, n=102), colonoscopy (n=271), or bidirectional endoscopy (n=25). The mean hospital stay was 2.72±1.66 days. The most common EGD results were atrophic gastritis (n=31), peptic ulcer (n=25), and negative findings (n=25). The most common colonoscopic results were negative findings (n=118), nonspecific colonic inflammatory changes (n=117), and non-bleeding hemorrhoids (n=29). We found no significant association between any endoscopic findings and age, gender, the severity of anemia, and length of hospitalization.

Conclusions

The presence of symptoms is of limited value in guiding diagnostic procedures concerning GI etiologies. Asymptomatic patients with IDA patients should receive an endoscopic examination irrespective of iron parameters, age, or gender for potentially treatable pathologies, especially for patients with suspected malignancies.

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Lenti MV, Rugge M, Lahner E, Miceli E, Toh BH, Genta RM, De Block C, Hershko C, Di Sabatino A. Autoimmune gastritis. Nat Rev Dis Primers 2020;6:56. [PMID: 32647173 DOI: 10.1038/s41572-020-0187-8] [Citation(s) in RCA: 199] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2020] [Indexed: 02/07/2023]

Lahner E, Conti L, Annibale B, Corleto VD. Current Perspectives in Atrophic Gastritis. Curr Gastroenterol Rep 2020;22:38. [PMID: 32542467 DOI: 10.1007/s11894-020-00775-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]

Burton JK, Yates LC, Whyte L, Fitzsimons E, Stott DJ. New horizons in iron deficiency anaemia in older adults. Age Ageing 2020;49:309-318. [PMID: 32103233 DOI: 10.1093/ageing/afz199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/17/2019] [Accepted: 01/02/2020] [Indexed: 12/24/2022] Open

Annibale B, Esposito G, Lahner E. A current clinical overview of atrophic gastritis. Expert Rev Gastroenterol Hepatol 2020;14:93-102. [PMID: 31951768 DOI: 10.1080/17474124.2020.1718491] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/16/2020] [Indexed: 02/08/2023]

Choo A, Bragagnolo A, Ekanayake SKDM, Alghamry A. Sustained resolution of anticoagulation related iron deficiency anemia with the use of apixaban. Clin Case Rep 2020;8:127-131. [PMID: 31998502 PMCID: PMC6982485 DOI: 10.1002/ccr3.2585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/13/2019] [Accepted: 10/31/2019] [Indexed: 11/25/2022] Open

Saraf SL, Gordeuk VR. Iron. ESSENTIAL AND TOXIC TRACE ELEMENTS AND VITAMINS IN HUMAN HEALTH 2020:83-102. [DOI: 10.1016/b978-0-12-805378-2.00006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]

Lahner E, Zagari RM, Zullo A, Di Sabatino A, Meggio A, Cesaro P, Lenti MV, Annibale B, Corazza GR. Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Italian Society of Internal Medicine [SIMI]. Dig Liver Dis 2019;51:1621-1632. [PMID: 31635944 DOI: 10.1016/j.dld.2019.09.016] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/03/2019] [Accepted: 09/23/2019] [Indexed: 02/08/2023]

Lenti MV, Lahner E, Bergamaschi G, Miceli E, Conti L, Massironi S, Cococcia S, Zilli A, Caprioli F, Vecchi M, Maiero S, Cannizzaro R, Corazza GR, Annibale B, Di Sabatino A. Cell Blood Count Alterations and Patterns of Anaemia in Autoimmune Atrophic Gastritis at Diagnosis: A Multicentre Study. J Clin Med 2019;8:1992. [PMID: 31731715 PMCID: PMC6912578 DOI: 10.3390/jcm8111992] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 02/06/2023] Open

Affiliation(s)

Marco Vincenzo Lenti First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
Edith Lahner Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Roma, Italy; (E.L.); (L.C.); (B.A.)
Gaetano Bergamaschi First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
Emanuela Miceli First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
Laura Conti Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Roma, Italy; (E.L.); (L.C.); (B.A.)
Sara Massironi Department of Gastroenterology and Endoscopy, IRCCS Ca’ Granda Foundation, University of Milan, 20122 Milano, Italy; (S.M.); (A.Z.); (F.C.); (M.V.)
Sara Cococcia First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
Alessandra Zilli Department of Gastroenterology and Endoscopy, IRCCS Ca’ Granda Foundation, University of Milan, 20122 Milano, Italy; (S.M.); (A.Z.); (F.C.); (M.V.)
Flavio Caprioli Department of Gastroenterology and Endoscopy, IRCCS Ca’ Granda Foundation, University of Milan, 20122 Milano, Italy; (S.M.); (A.Z.); (F.C.); (M.V.)
Maurizio Vecchi Department of Gastroenterology and Endoscopy, IRCCS Ca’ Granda Foundation, University of Milan, 20122 Milano, Italy; (S.M.); (A.Z.); (F.C.); (M.V.)
Stefania Maiero Oncological Gastroenterology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (S.M.)
Renato Cannizzaro Oncological Gastroenterology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (S.M.)
Gino Roberto Corazza First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
Bruno Annibale Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Roma, Italy; (E.L.); (L.C.); (B.A.)
Antonio Di Sabatino First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)

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Matsukuma K, Torbenson M. Autoimmune Gastritis: An Underappreciated Entity. AJSP: REVIEWS AND REPORTS 2019;24:150-156. [DOI: 10.1097/pcr.0000000000000320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]

Auerbach M, Spivak J. Treatment of Iron Deficiency in the Elderly: A New Paradigm. Clin Geriatr Med 2019;35:307-317. [PMID: 31230732 DOI: 10.1016/j.cger.2019.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]

Elli L, Norsa L, Zullo A, Carroccio A, Girelli C, Oliva S, Romano C, Leandro G, Bellini M, Marmo R, Soncini M, Monica F, De Francesco V, Paulon E, Cappellini MD, Motta I, Ferretti F, Orlando S, Mansueto P, Buscarini E, Manfredi G, Agostoni C, Tomba C, Cannizzaro R. Diagnosis of chronic anaemia in gastrointestinal disorders: A guideline by the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) and the Italian Society of Paediatric Gastroenterology Hepatology and Nutrition (SIGENP). Dig Liver Dis 2019;51:471-483. [PMID: 30850345 DOI: 10.1016/j.dld.2019.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/18/2019] [Accepted: 01/29/2019] [Indexed: 12/11/2022]

Affiliation(s)

Luca Elli Gastroenterology and Endoscopy Division/Center for Prevention and Diagnosis of Coeliac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano.
Lorenzo Norsa Division of Paediatric Gastroenterology, Hepatology and Transplantation, ASST "Pope Giovanni XXIII", Bergamo
Angelo Zullo Gastroenterology and Digestive Endoscopy, "Nuovo Regina Margherita" Hospital, Rome
Antonio Carroccio Internal Medicine, "Giovanni Paolo II" Hospital, Sciacca; Biomedical Department of Internal and Specialist Medicine - DiBiMIS, University of Palermo, Palermo
Carlo Girelli Gastroenterology and Digestive Endoscopy Unit, Hospital of Busto Arsizio, Busto Arsizio
Salvatore Oliva Paediatric Gastroenterology and Liver Unit, University "La Sapienza" of Rome, Roma
Claudio Romano Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina
Gioacchino Leandro National Institute of Gastroenterology "S. De Bellis" Research Hospital, Castellana Grotte, Italy
Massimo Bellini Gastrointestinal Unit, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa
Riccardo Marmo Gastroenterology ed Endoscopy, Polla Hospital, Salerno
Marco Soncini Internal Medicine, "Alessandro Manzoni" Hospital, ASST-Lecco, Lecco
Fabio Monica Gastroenterology and Digestive Endoscopy Unit, Cattinara Hospital, Trieste
Vincenzo De Francesco Gastroenterology Unit, "Riuniti" Hospital, Foggia, Italy
Emma Paulon Gastroenterology and Digestive Endoscopy Unit, Cattinara Hospital, Trieste
Maria Domenica Cappellini Rare Diseases Center, Department of Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano; Department of Clinical Sciences and Community Health, University of Milan, Milano
Irene Motta Rare Diseases Center, Department of Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano; Department of Clinical Sciences and Community Health, University of Milan, Milano
Francesca Ferretti Gastroenterology and Endoscopy Division/Center for Prevention and Diagnosis of Coeliac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
Stefania Orlando Gastroenterology and Endoscopy Division/Center for Prevention and Diagnosis of Coeliac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
Pasquale Mansueto Biomedical Department of Internal and Specialist Medicine - DiBiMIS, University of Palermo, Palermo
Elisabetta Buscarini Gastroenterology Unit, ASST Ospedale Maggiore di Crema, Crema
Guido Manfredi Gastroenterology Unit, ASST Ospedale Maggiore di Crema, Crema
Carlo Agostoni Paediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano; Department of Clinical Sciences and Community Health, University of Milan, Milano
Carolina Tomba Gastroenterology 2, ASST Papa Giovannin XXIII, Bergamo
Renato Cannizzaro Oncological Gastroenterology Division, Centro di Riferimento Oncologico (CRO) IRCCS, Aviano

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Congestive Heart Failure and Upper Digestive Endoscopic Lesions. ACTA MEDICA MARISIENSIS 2019. [DOI: 10.2478/amma-2019-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open

Zullo A, Manta R, De Francesco V, Fiorini G, Lahner E, Vaira D, Annibale B. Cameron lesions: A still overlooked diagnosis. Case report and systematic review of literature. Clin Res Hepatol Gastroenterol 2018;42:604-609. [PMID: 29910147 DOI: 10.1016/j.clinre.2018.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 05/11/2018] [Indexed: 02/08/2023]

Kulnigg-Dabsch S, Resch M, Oberhuber G, Klinglmueller F, Gasche A, Gasche C. Iron deficiency workup reveals high incidence of autoimmune gastritis with parietal cell antibody as reliable screening test. Semin Hematol 2018;55:256-261. [PMID: 30502855 DOI: 10.1053/j.seminhematol.2018.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/12/2018] [Accepted: 07/29/2018] [Indexed: 12/28/2022]

Mahadev S, Laszkowska M, Sundström J, Björkholm M, Lebwohl B, Green PHR, Ludvigsson JF. Prevalence of Celiac Disease in Patients With Iron Deficiency Anemia-A Systematic Review With Meta-analysis. Gastroenterology 2018;155:374-382.e1. [PMID: 29689265 PMCID: PMC7057414 DOI: 10.1053/j.gastro.2018.04.016] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/10/2018] [Accepted: 04/17/2018] [Indexed: 02/06/2023]

Abstract

BACKGROUND & AIMS

Anemia is common in patients with celiac disease (CD) and a frequent mode of presentation. Guidelines recommend screening patients with iron-deficiency anemia (IDA) for CD. However, the reported prevalence of CD in patients with IDA varies. We performed a systematic review to determine the prevalence of biopsy-verified CD in patients with IDA.

METHODS

We performed a systematic review of articles published in PubMed Medline or EMBASE through July 2017 for the term "celiac disease" combined with "anemia" or "iron deficiency." We used fixed-effects inverse variance-weighted models to measure the pooled prevalence of CD. Meta-regression was used to assess subgroup heterogeneity.

RESULTS

We identified 18 studies composed of 2998 patients with IDA for inclusion in our analysis. Studies originated from the United Kingdom, United States, Italy, Turkey, Iran, and Israel. The crude unweighted prevalence of CD was 4.8% (n = 143). Using a weighted pooled analysis, we found a prevalence of biopsy-confirmed CD of 3.2% (95% confidence interval = 2.6-3.9) in patients with IDA. However, heterogeneity was high (I2 = 67.7%). The prevalence of CD was not significantly higher in studies with a mean participant age older or younger than 18 years or in studies with a mixed-sex vs female-predominant (≥60%) population. On meta-regression, year of publication, female proportion, age at CD testing, and prevalence in the general population were not associated with the prevalence of CD in patients with IDA. In the 8 studies fulfilling all our quality criteria, the pooled prevalence of CD was 5.5% (95% confidence interval = 4.1-6.9).

CONCLUSIONS

In a systematic review and meta-analysis, we found that approximately 1 in 31 patients with IDA have histologic evidence of CD. This prevalence value justifies the practice of testing patients with IDA for CD.

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Elloumi H, Sabbah M, Debbiche A, Ouakaa A, Bibani N, Trad D, Gargouri D, Kharrat J. Systematic gastric biopsy in iron deficiency anaemia. Arab J Gastroenterol 2017;18:224-227. [PMID: 29273468 DOI: 10.1016/j.ajg.2017.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 09/22/2017] [Accepted: 11/19/2017] [Indexed: 02/08/2023]

Abstract

BACKGROUND AND STUDY AIMS

Gastric biopsies are recommended in patients with iron deficiency anaemia to identify atrophic gastritis. However, in practice, only duodenal biopsies are routinely performed. The aim of our study was to determine the value of gastric biopsies in iron deficiency anaemia.

PATIENTS AND METHODS

A prospective study including all patients referred for gastrointestinal endoscopy for iron deficiency anaemia from May 2008 to September 2014 was performed. All patients having endoscopic lesions which may explain occult bleeding were excluded, as well as patients using non-steroidal anti-inflammatory drugs or anticoagulation treatment. Two fundic biopsies, two antral biopsies, and one biopsy from the lesser curve were taken in all patients. Following entities were particularly looked for: chronic gastritis, Helicobacter pylori infection, intestinal metaplasia, endocrine hyperplasia and villous atrophy. In cases where intestinal metaplasia was present in the fundus and associated with endocrine hyperplasia and glandular atrophy, immunohistochemical study was performed to confirm autoimmune gastritis.

RESULTS

One hundred seventy-seven patients (mean age 50 years, range: 15-90) were included. Chronic gastritis was found in 149 cases (84%). Infection by Helicobacter pylori was found in 107 cases (60%). Fundic intestinal metaplasia was observed in 25 patients (14%) and was associated with Helicobacter pylori infection in 52% of cases. Atrophic gastritis was observed in 14 cases (8%) and autoimmune gastritis was confirmed in 5 cases by immunohistochemical study. One patient had on gastric biopsy a carcinoma with signet ring cells.

CONCLUSION

Intestinal metaplasia was frequently observed and was mostly related to Helicobacter pylori infection. These patients require monitoring, especially if they are young because it represents a pre neoplastic condition. However, in our study autoimmune gastritis often described in the literature in case of iron deficiency anaemia was rarely seen raising the question of relative cost-efficiency of fundic biopsies during iron deficiency anaemia.

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Joosten E. Iron deficiency anemia in older adults: A review. Geriatr Gerontol Int 2017;18:373-379. [PMID: 29094497 DOI: 10.1111/ggi.13194] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2017] [Indexed: 12/24/2022]

Clere-Jehl R, Schaeffer M, Vogel T, Kiesmann M, Pasquali JL, Andres E, Bourgarit A, Goichot B. Upper and lower gastrointestinal endoscopies in patients over 85 years of age: Risk-benefit evaluation of a longitudinal cohort. Medicine (Baltimore) 2017;96:e8439. [PMID: 29095285 PMCID: PMC5682804 DOI: 10.1097/md.0000000000008439] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open

Abstract

After age 85, upper and lower gastrointestinal (GI) endoscopy may be indicated in 5% to 10% of inpatients, but the risk-benefit ratio is unknown. We studied patients older than 85 years undergoing upper and lower GI endoscopy.We analyzed a retrospective cohort of inpatients older than 85 years between 2004 and 2012, all explored by upper and complete lower GI endoscopy. Initial indications, including iron deficiency anemia (IDA), other anemias, GI bleeding, weight loss, and GI symptoms, were noted, as were endoscopy or anesthesia complications, immediate endoscopic diagnosis, and the ability to modify the patients' therapeutics. Deaths and final diagnosis for initial endoscopic indication were analyzed after at least 12 months.We included 55 patients, 78% women, with a median age, reticulocyte count, hemoglobin, and ferritin levels of 87 (85-99), 56 (24-214) g/L, 8.6 (4.8-12.9) g/dL, and 56 (3-799) μg/L, respectively. IDA was the most frequent indication for endoscopy (60%; n = 33). Immediate diagnoses were found in 64% of the patients (n = 35), including 25% with GI cancers (n = 14) and 22% with gastroduodenal ulcers or erosions (n = 12). Cancer diagnosis was associated with lower reticulocyte count (45 vs. 60 G/L; P = .02). Among the 35 diagnoses, 94% (n = 33) led to modifications of the patients' therapeutics, with 29% of the patients deciding on palliative care (n = 10). No endoscopic complications lead to death. Follow-up of >12 months was available in 82% (n = 45) of the patients; among these patients, 40% (n = 27) died after an average 24 ± 18 months. Cancer diagnosis was significantly associated with less ulterior red cell transfusion (0% vs. 28%; P = .02) and fewer further investigations (6.7% vs. 40%; P = .02).Upper and complete lower GI endoscopy in patients older than 85 years appears to be safe, and enables a high rate of immediate diagnosis, with significant modifications of therapeutics. GI cancers represented more than one-third of the endoscopic diagnoses.

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Shahriari-Ahmadi A, Shalbaf N, Masoodi M, Shalbaf M, Bozorgi V, Sadeghi M. Endoscopic and Colonoscopic Findings in Patients with Iron Deficiency Anemia: The Risk of Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017;10. [DOI: 10.5812/ijcm.8222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]

Villanacci V, Casella G, Lanzarotto F, Di Bella C, Sidoni A, Cadei M, Salviato T, Dore MP, Bassotti G. Autoimmune gastritis: relationships with anemia and Helicobacter pylori status. Scand J Gastroenterol 2017;52:674-677. [PMID: 28276835 DOI: 10.1080/00365521.2017.1288758] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 01/26/2017] [Indexed: 02/06/2023]

Bosch X, Montori E, Guerra-García M, Costa-Rodríguez J, Quintanilla MH, Tolosa-Chapasian PE, Moreno P, Guasch N, López-Soto A. A comprehensive evaluation of the gastrointestinal tract in iron-deficiency anemia with predefined hemoglobin below 9mg/dL: A prospective cohort study. Dig Liver Dis 2017;49:417-426. [PMID: 28065528 DOI: 10.1016/j.dld.2016.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 12/06/2016] [Accepted: 12/09/2016] [Indexed: 12/11/2022]

Cavalcoli F, Zilli A, Conte D, Massironi S. Micronutrient deficiencies in patients with chronic atrophic autoimmune gastritis: A review. World J Gastroenterol 2017;23:563-572. [PMID: 28216963 PMCID: PMC5292330 DOI: 10.3748/wjg.v23.i4.563] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 10/08/2016] [Accepted: 11/12/2016] [Indexed: 02/06/2023] Open

Clere-Jehl R, Sauleau E, Ciuca S, Schaeffer M, Lopes A, Goichot B, Vogel T, Kaltenbach G, Bouvard E, Pasquali JL, Sereni D, Andres E, Bourgarit A. Outcome of endoscopy-negative iron deficiency anemia in patients above 65: A longitudinal multicenter cohort. Medicine (Baltimore) 2016;95:e5339. [PMID: 27893668 PMCID: PMC5134861 DOI: 10.1097/md.0000000000005339] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open

Abstract

After the age of 65 years, iron deficiency anemia (IDA) requires the elimination of digestive neoplasia and is explored with upper and lower gastrointestinal (GI) endoscopy. However, such explorations are negative in 14% to 37% of patients. To further evaluate this issue, we evaluated the outcomes of patients aged over 65 years with endoscopy-negative IDA.We retrospectively analyzed the outcomes of in-patients over the age of 65 years with IDA (hemoglobin <12 g/dL and ferritin <70 μg/L) who had negative complete upper and lower GI endoscopies in 7 tertiary medical hospitals. Death, the persistence of anemia, further investigations, and the final diagnosis for IDA were analyzed after at least 12 months by calling the patients' general practitioners and using hospital records.Between 2004 and 2011, 69 patients (74% women) with a median age of 78 (interquartile range (IQR) 75-82) years and hemoglobin and ferritin levels of 8.4 (IQR 6.8-9.9) g/dL and 14 (IQR 8-27) μg/L, respectively, had endoscopy-negative IDA, and 73% of these patients received daily antithrombotics. After a follow-up of 41 ± 22 months, 23 (33%) of the patients were dead; 5 deaths were linked with the IDA, and 45 (65%) patients had persistent anemia, which was significantly associated with death (P = 0.007). Further investigations were performed in 45 patients; 64% of the second-look GI endoscopies led to significant changes in treatment compared with 25% for the capsule endoscopies. Conventional diagnoses of IDA were ultimately established for 19 (27%) patients and included 3 cancer patients. Among the 50 other patients, 40 (58%) had antithrombotics.In endoscopy-negative IDA over the age of 65 years, further investigations should be reserved for patients with persistent anemia, and second-look GI endoscopy should be favored. If the results of these investigations are negative, the role of antithrombotics should be considered.

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Kulnigg-Dabsch S. Autoimmune gastritis. Wien Med Wochenschr 2016;166:424-430. [PMID: 27671008 PMCID: PMC5065578 DOI: 10.1007/s10354-016-0515-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/05/2016] [Indexed: 12/12/2022]

[Diagnostic approach to iron deficiency anemia]. Wien Med Wochenschr 2016;166:402-410. [PMID: 27565993 DOI: 10.1007/s10354-016-0495-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]

Varcher M, Zisimopoulou S, Braillard O, Favrat B, Junod Perron N. Iron deficiency intravenous substitution in a Swiss academic primary care division: analysis of practices. Int J Gen Med 2016;9:221-7. [PMID: 27445502 PMCID: PMC4938240 DOI: 10.2147/ijgm.s107821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open

Abstract

Background

Iron deficiency is a common problem in primary care and is usually treated with oral iron substitution. With the recent simplification of intravenous (IV) iron administration (ferric carboxymaltose) and its approval in many countries for iron deficiency, physicians may be inclined to overutilize it as a first-line substitution.

Objective

The aim of this study was to evaluate iron deficiency management and substitution practices in an academic primary care division 5 years after ferric carboxymaltose was approved for treatment of iron deficiency in Switzerland.

Methods

All patients treated for iron deficiency during March and April 2012 at the Geneva University Division of Primary Care were identified. Their medical files were analyzed for information, including initial ferritin value, reasons for the investigation of iron levels, suspected etiology, type of treatment initiated, and clinical and biological follow-up. Findings were assessed using an algorithm for iron deficiency management based on a literature review.

Results

Out of 1,671 patients, 93 were treated for iron deficiency. Median patients’ age was 40 years and 92.5% (n=86) were female. The average ferritin value was 17.2 μg/L (standard deviation 13.3 μg/L). The reasons for the investigation of iron levels were documented in 82% and the suspected etiology for iron deficiency was reported in 67%. Seventy percent of the patients received oral treatment, 14% IV treatment, and 16% both. The reasons for IV treatment as first- and second-line treatment were reported in 57% and 95%, respectively. Clinical and biological follow-up was planned in less than two-thirds of the cases.

Conclusion

There was no clear overutilization of IV iron substitution. However, several steps of the iron deficiency management were not optimally documented, suggesting shortcuts in clinical reasoning.

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Evaluation of iron deficiency anaemia for gastrointestinal causes in patients without GI symptoms in high prevalent GI malignancy zones. Arab J Gastroenterol 2016;17:67-72. [PMID: 27426957 DOI: 10.1016/j.ajg.2016.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 01/26/2016] [Accepted: 05/27/2016] [Indexed: 01/05/2023]

Akin M, Sarbay H, Guler S, Balci YI, Polat A. Response to parenteral iron therapy distinguish unexplained refractory iron deficiency anemia from iron-refractory iron deficiency anemia. Int J Lab Hematol 2016;38:167-71. [PMID: 26818204 DOI: 10.1111/ijlh.12462] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 12/04/2015] [Indexed: 11/30/2022]