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Endoscopic evaluation of significant gastrointestinal lesions in patients with iron deficiency with and without anaemia: a Korean Association for the Study of Intestinal Disease study.
Intern Med J. 2009 Jul; 39(7):441-6.IM

Abstract

BACKGROUND

Although endoscopy is recommended for patients with iron deficiency anaemia, there is, currently, no consensus on the role of endoscopy for iron-deficient patients without anaemia. The goal of this study was to determine the prevalence of serious gastrointestinal (GI) lesions, identified by endoscopy in patients with iron deficiency and anaemia compared with patients with iron deficiency without anaemia.

METHODS

One thousand five hundred and eighteen patients with a ferritin value of <or=50 ng/mL and a total iron-binding capacity >or=300 mg/dL were retrospectively investigated using oesophagogastroduodenoscopy and colonoscopy between January 2005 and September 2006. The lesions identified were classified as clinically important according to standard predetermined criteria.

RESULTS

Among the 1518 cases, 749 patients had anaemia and 769 had normal haemoglobin levels. Clinically important lesions were identified in 24.6% of the patients with anaemia and in 22.8% of the patients without anaemia (P > 0.05). The frequency of lower GI tract lesions (13.6 vs 11.4%, P > 0.05) and upper GI tract lesions (11.9 vs 12.5%, P > 0.05) was similar in the comparisons between the two groups. However, the frequency of malignant GI lesions was higher in the patients with anaemia (5.1 vs 0.7%, P < 0.01). In addition, the patients without anaemia were significantly more likely to have early-stage neoplasia (adenoma, early gastric cancer and Dukes' A and B colon cancer) than were the patients with anaemia (98.4 vs 52.5%, P < 0.01).

CONCLUSION

The results of this study suggest that patients with iron deficiency should undergo endoscopic evaluation of the GI tract, irrespective of whether they have anaemia. The endoscopic evaluation of the GI tract in patients with iron deficiency without anaemia could provide an opportunity for the detection of early-stage neoplasia at a curable stage.

Authors+Show Affiliations

Department of Internal Medicine, Kangbuk Samsung Hospital, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

19220549

Citation

Park, J S., et al. "Endoscopic Evaluation of Significant Gastrointestinal Lesions in Patients With Iron Deficiency With and Without Anaemia: a Korean Association for the Study of Intestinal Disease Study." Internal Medicine Journal, vol. 39, no. 7, 2009, pp. 441-6.
Park JS, Park DI, Park SK, et al. Endoscopic evaluation of significant gastrointestinal lesions in patients with iron deficiency with and without anaemia: a Korean Association for the Study of Intestinal Disease study. Intern Med J. 2009;39(7):441-6.
Park, J. S., Park, D. I., Park, S. K., Choi, J. S., Kim, Y. H., Chang, D. K., Son, H. J., Kim, J. E., Kim, J. O., Lee, S. H., Kim, H. S., Sin, J. E., Lee, S. G., Lee, S. Y., Park, S. J., Park, C. H., Baek, I. H., Jang, B. I., Jeen, Y. T., & Huh, K. C. (2009). Endoscopic evaluation of significant gastrointestinal lesions in patients with iron deficiency with and without anaemia: a Korean Association for the Study of Intestinal Disease study. Internal Medicine Journal, 39(7), 441-6. https://doi.org/10.1111/j.1445-5994.2008.01785.x
Park JS, et al. Endoscopic Evaluation of Significant Gastrointestinal Lesions in Patients With Iron Deficiency With and Without Anaemia: a Korean Association for the Study of Intestinal Disease Study. Intern Med J. 2009;39(7):441-6. PubMed PMID: 19220549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic evaluation of significant gastrointestinal lesions in patients with iron deficiency with and without anaemia: a Korean Association for the Study of Intestinal Disease study. AU - Park,J S, AU - Park,D I, AU - Park,S K, AU - Choi,J S, AU - Kim,Y H, AU - Chang,D K, AU - Son,H J, AU - Kim,J E, AU - Kim,J O, AU - Lee,S H, AU - Kim,H S, AU - Sin,J E, AU - Lee,S G, AU - Lee,S-Y, AU - Park,S J, AU - Park,C H, AU - Baek,I H, AU - Jang,B I, AU - Jeen,Y T, AU - Huh,K C, Y1 - 2008/08/15/ PY - 2009/2/18/entrez PY - 2009/2/18/pubmed PY - 2010/4/21/medline SP - 441 EP - 6 JF - Internal medicine journal JO - Intern Med J VL - 39 IS - 7 N2 - BACKGROUND: Although endoscopy is recommended for patients with iron deficiency anaemia, there is, currently, no consensus on the role of endoscopy for iron-deficient patients without anaemia. The goal of this study was to determine the prevalence of serious gastrointestinal (GI) lesions, identified by endoscopy in patients with iron deficiency and anaemia compared with patients with iron deficiency without anaemia. METHODS: One thousand five hundred and eighteen patients with a ferritin value of <or=50 ng/mL and a total iron-binding capacity >or=300 mg/dL were retrospectively investigated using oesophagogastroduodenoscopy and colonoscopy between January 2005 and September 2006. The lesions identified were classified as clinically important according to standard predetermined criteria. RESULTS: Among the 1518 cases, 749 patients had anaemia and 769 had normal haemoglobin levels. Clinically important lesions were identified in 24.6% of the patients with anaemia and in 22.8% of the patients without anaemia (P > 0.05). The frequency of lower GI tract lesions (13.6 vs 11.4%, P > 0.05) and upper GI tract lesions (11.9 vs 12.5%, P > 0.05) was similar in the comparisons between the two groups. However, the frequency of malignant GI lesions was higher in the patients with anaemia (5.1 vs 0.7%, P < 0.01). In addition, the patients without anaemia were significantly more likely to have early-stage neoplasia (adenoma, early gastric cancer and Dukes' A and B colon cancer) than were the patients with anaemia (98.4 vs 52.5%, P < 0.01). CONCLUSION: The results of this study suggest that patients with iron deficiency should undergo endoscopic evaluation of the GI tract, irrespective of whether they have anaemia. The endoscopic evaluation of the GI tract in patients with iron deficiency without anaemia could provide an opportunity for the detection of early-stage neoplasia at a curable stage. SN - 1445-5994 UR - https://www.unboundmedicine.com/medline/citation/19220549/Endoscopic_evaluation_of_significant_gastrointestinal_lesions_in_patients_with_iron_deficiency_with_and_without_anaemia:_a_Korean_Association_for_the_Study_of_Intestinal_Disease_study_ L2 - https://doi.org/10.1111/j.1445-5994.2008.01785.x DB - PRIME DP - Unbound Medicine ER -