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Gastropathic sideropenia.
Best Pract Res Clin Haematol. 2005 Jun; 18(2):363-80.BP

Abstract

There has been an increasing awareness recently of subtle, non-bleeding gastrointestinal conditions that may result in abnormal iron absorption leading to iron-deficiency anaemia (IDA) in the absence of gastrointestinal symptoms. Thus, the importance of coeliac disease as a possible cause of IDA refractory to oral iron treatment, without other manifestations of malabsorption syndrome, is increasingly being recognized. In addition, Helicobacter pylori has been implicated in several recent studies as a cause of IDA refractory to oral iron treatment, and the anaemia responds favourably to H. pylori eradication. Likewise, achlorhydric gastric atrophy or atrophic body gastritis (ABG), a condition associated with chronic idiopathic iron deficiency, has been shown to be responsible for refractory IDA in over 20% of patients with no evidence of gastrointestinal blood loss. It has also been suggested that H. pylori gastritis may represent an early phase of ABG in which infection may trigger an autoimmune process directed against gastric parietal cells by means of antigenic mimicry. In this review we examine in a critical manner the role of H. pylori gastritis in the causation of IDA, the role of ABG in the pathogenesis of iron malabsorption, the evidence supporting a possible cause-and-effect relationship between H. pylori gastritis and ABG, and the implications of these findings for the diagnostic work-up and management of IDA.

Authors+Show Affiliations

Department of Haematology, Shaare Zedek Medical Center, Hebrew University Hadassah Medical School, Jerusalem 91031, Israel. hershko@szmc.org.ilNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15737896

Citation

Hershko, Chaim, et al. "Gastropathic Sideropenia." Best Practice & Research. Clinical Haematology, vol. 18, no. 2, 2005, pp. 363-80.
Hershko C, Lahad A, Kereth D. Gastropathic sideropenia. Best Pract Res Clin Haematol. 2005;18(2):363-80.
Hershko, C., Lahad, A., & Kereth, D. (2005). Gastropathic sideropenia. Best Practice & Research. Clinical Haematology, 18(2), 363-80.
Hershko C, Lahad A, Kereth D. Gastropathic Sideropenia. Best Pract Res Clin Haematol. 2005;18(2):363-80. PubMed PMID: 15737896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastropathic sideropenia. AU - Hershko,Chaim, AU - Lahad,Amnon, AU - Kereth,Dan, PY - 2005/3/2/pubmed PY - 2005/8/18/medline PY - 2005/3/2/entrez SP - 363 EP - 80 JF - Best practice & research. Clinical haematology JO - Best Pract Res Clin Haematol VL - 18 IS - 2 N2 - There has been an increasing awareness recently of subtle, non-bleeding gastrointestinal conditions that may result in abnormal iron absorption leading to iron-deficiency anaemia (IDA) in the absence of gastrointestinal symptoms. Thus, the importance of coeliac disease as a possible cause of IDA refractory to oral iron treatment, without other manifestations of malabsorption syndrome, is increasingly being recognized. In addition, Helicobacter pylori has been implicated in several recent studies as a cause of IDA refractory to oral iron treatment, and the anaemia responds favourably to H. pylori eradication. Likewise, achlorhydric gastric atrophy or atrophic body gastritis (ABG), a condition associated with chronic idiopathic iron deficiency, has been shown to be responsible for refractory IDA in over 20% of patients with no evidence of gastrointestinal blood loss. It has also been suggested that H. pylori gastritis may represent an early phase of ABG in which infection may trigger an autoimmune process directed against gastric parietal cells by means of antigenic mimicry. In this review we examine in a critical manner the role of H. pylori gastritis in the causation of IDA, the role of ABG in the pathogenesis of iron malabsorption, the evidence supporting a possible cause-and-effect relationship between H. pylori gastritis and ABG, and the implications of these findings for the diagnostic work-up and management of IDA. SN - 1521-6926 UR - https://www.unboundmedicine.com/medline/citation/15737896/Gastropathic_sideropenia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1521-6926(04)00125-2 DB - PRIME DP - Unbound Medicine ER -