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Anemia in Pediatric Inflammatory Bowel Disease
Ghanim Aljomah1, Susan S Baker1, Kenneth Schmidt2
1Digestive Diseases & Nutrition Center, Women & Children's Hospital of Buffalo, SUNY at Buffalo.
Insights
Anemia is common in pediatric inflammatory bowel disease (IBD), affecting over 67% at diagnosis. While anemia prevalence decreased at 1 year, it persisted, with anemia of chronic disease being most common in Crohn disease.
Area of Science:
- Pediatric Gastroenterology
- Hematology
- Inflammatory Bowel Disease (IBD) Research
Background:
- Anemia is a frequent extra-intestinal manifestation in pediatric patients with Inflammatory Bowel Disease (IBD).
- Understanding the prevalence and types of anemia at diagnosis and during follow-up is crucial for effective management.
Purpose of the Study:
- To determine the prevalence and types of anemia in pediatric patients diagnosed with IBD.
- To assess anemia at diagnosis and approximately one year post-diagnosis.
Main Methods:
- Retrospective chart review of pediatric IBD patients (ages 1-18) diagnosed between 2005-2012.
- Inclusion criteria: hemoglobin, hematocrit, MCV, and iron indices at diagnosis and 1-year follow-up.
- Anemia typing utilized the soluble transferrin receptor index.
Main Results:
- At diagnosis, 67.31% of pediatric IBD patients had anemia.
- Iron deficiency anemia (IDA) or combined IDA/anemia of chronic disease (ACD) affected 28.85%, while 38.46% had ACD alone.
- At 1-year follow-up, anemia prevalence decreased to 20.51%, with 15.38% having IDA or combined IDA/ACD and 5.13% having ACD alone.
Conclusions:
- Anemia is highly prevalent in pediatric IBD, particularly in Crohn disease (CD).
- Anemia significantly decreased but persisted at 1 year post-diagnosis.
- Anemia of chronic disease was predominant in CD, while IDA persisted in both CD and ulcerative colitis.
Objectives:
Anemia is the most frequent extra-intestinal finding in inflammatory bowel disease (IBD). The aim of this study is to determine the prevalence and types of anemia in pediatric patients with IBD at diagnosis and at approximately 1 year follow-up.
Methods:
This is a retrospective chart review of patients diagnosed with IBD from 2005 to 2012, ages 1 to 18 years. Patients who had hemoglobin, hematocrit, mean corpuscular volume, and iron indices obtained at the time of diagnosis and at approximately 1 year follow-up were included in the study. The prevalence of anemia at the beginning and the end of the study was recorded. Using the soluble transferrin receptor index the type of anemia was determined.
Results:
At diagnosis, 67.31% of patients were anemic. Overall, 28.85% of patients had either iron deficiency anemia (IDA) or a combination of IDA and anemia of chronic disease (ACD), whereas 38.46% had ACD alone. At follow-up, 20.51% were anemic. 15.38% had either IDA or a combination of IDA and ACD; 5.13% had ACD alone. The pattern of anemia and response to therapy differed among the IBD phenotypes CONCLUSIONS:: Anemia is frequent in inflammatory bowel disease. The prevalence was higher in Crohn disease (CD). At 1 year, the prevalence of anemia decreased significantly, but persisted. Anemia of chronic disease predominated in CD. Iron deficiency anemia continued to be present in CD and ulcerative colitis.
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