Systematic review: managing anaemia in Crohn's disease.

Abstract:

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.

journal_name

Aliment Pharmacol Ther

authors

Kulnigg S,Gasche C

doi

10.1111/j.1365-2036.2006.03146.x

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

1507-23

issue

11-12

eissn

0269-2813

issn

1365-2036

pii

APT3146

journal_volume

24

pub_type

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