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Systematic review: managing anaemia in Crohn's disease
1Department of Medicine, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
Insights
Anaemia is a common complication of Crohn's disease, often caused by iron deficiency. Intravenous iron is a safe and effective treatment for anaemia in Crohn's disease patients.
Area of Science:
- Gastroenterology
- Hematology
- Internal Medicine
Background:
- Anaemia is a significant complication of Crohn's disease, potentially leading to hospitalization and mortality.
- The prevalence of anaemia in Crohn's disease varies widely, with higher rates reported in older studies and inpatient populations.
Purpose of the Study:
- To systematically review and compare existing literature on anaemia in Crohn's disease.
- To synthesize information on prevalence, causes, diagnostic methods, and therapeutic approaches.
Main Methods:
- A systematic literature search was conducted using keywords: anaemia, Crohn*, and IBD.
- 144 English-language articles were identified and categorized by topic.
- Data were analyzed to summarize findings on prevalence, aetiology, diagnostics, and therapy.
Main Results:
- Iron deficiency is the most frequent cause of anaemia in Crohn's disease.
- While oral iron supplementation may be effective short-term, intolerance is common (up to 21%) and it may exacerbate intestinal inflammation in animal models.
- Intravenous iron sucrose has demonstrated safety and efficacy in over 250 Crohn's disease patients.
Conclusions:
- Effective management of Crohn's disease activity is crucial for reducing anaemia incidence.
- Further research is necessary to fully establish the safety and effectiveness of iron supplementation strategies.
Background:
Anaemia is a serious complication of Crohn's disease that triggers hospitalization and, if not interfered with, may lead to death.
Aims:
To systematically summarize and compare the literature on anaemia in Crohn's disease.
Methods:
For this systematic review the literature was searched for English-language articles using anaemia, Crohn* and IBD as key words. 144 articles were identified and sorted according to the following topics: prevalence, aetiology, diagnostic tests and therapy.
Results:
The reported prevalence of anaemia varied between 6.2% and 73.7%, with higher reported frequencies in older studies and in in-patients. Iron deficiency is the most common underlying condition. Vitamin B12 deficiency is related to the extent of ileal resection but has rarely impact on anaemia. Diagnostic criteria are not established and treatment guidelines are missing. Oral iron supplementation seems effective for short periods but intolerance leads to discontinuation in up to 21%. Eleven of 11 studies show that oral iron enhances intestinal inflammation and colon carcinogenesis in animal models of colitis. Intravenous iron supplementation with iron sucrose has been tested in over 250 Crohn's disease patients, is safe, effective and does not carry such hazards.
Conclusions:
As disease activity is determining the degree of anaemia in Crohn's disease, implementation of more effective therapy for Crohn's disease will lower its incidence. However, further studies regarding the safety and effectiveness of iron supplementation are needed.
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