Anemia in Pediatric Inflammatory Bowel Disease

Aljomah G1, Baker SS1, Schmidt K2, Alkhouri R1, Kozielski R3, Zhu L1, Baker RD1. J Pediatr Gastroenterol Nutr. 2018 Sep;67(3):351-355. doi: 10.1097/MPG.0000000000002002.

Author information

1 Digestive Diseases & Nutrition Center, Women & Children's Hospital of Buffalo, SUNY at Buffalo.

2 Jacob's School of Medicine and Biomedical Sciences, University at Buffalo.

3 Department of Pathology, Women & Children's Hospital of Buffalo, SUNY at Buffalo, Buffalo, NY.


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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