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Pathogenesis and management of iron deficiency anemia: emerging role of celiac disease, helicobacter pylori, and autoimmune gastritis.
Semin Hematol. 2009 Oct; 46(4):339-50.SH

Abstract

The causes of iron deficiency vary significantly during different stages of life, and according to gender and socioeconomic circumstances. Although dietary iron is important, iron deficiency anemia (IDA) is mostly attributed to blood loss and may be the presenting clinical feature of occult bleeding from the gastrointestinal (GI) tract heralding underlying malignancy. Conventional GI diagnostic workup fails to establish the cause of iron deficiency in about one third of patients. However, abnormal iron absorption caused by hereditary iron-refractory iron deficiency anemia (IRIDA) or acquired disease is increasingly recognized as an important cause of unexplained iron deficiency. The recent availability of convenient, non-invasive screening methods to identify celiac disease, autoimmune atrophic gastritis and Helicobacter pylori infection has greatly facilitated the recognition of patients with these entities. Cure of previously refractory IDA by H pylori eradication provides strong evidence supporting a cause-and-effect relation. The intriguing recent observations of H pylori antibodies directed against epitopes on gastric mucosal cells in atrophic gastritis imply an autoimmune mechanism triggered by H pylori and directed against gastric parietal cells by means of antigenic mimicry. Improved understanding of the role of abnormal iron absorption in IDA has important implications for current concepts related to the pathogenesis and management of IDA.

Authors+Show Affiliations

Department of Hematology, Shaare Zedek Medical Center and Hebrew University of Jerusalem, Israel. hershkoc@netvision.net.ilNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19786202

Citation

Hershko, Chaim, and Barry Skikne. "Pathogenesis and Management of Iron Deficiency Anemia: Emerging Role of Celiac Disease, Helicobacter Pylori, and Autoimmune Gastritis." Seminars in Hematology, vol. 46, no. 4, 2009, pp. 339-50.
Hershko C, Skikne B. Pathogenesis and management of iron deficiency anemia: emerging role of celiac disease, helicobacter pylori, and autoimmune gastritis. Semin Hematol. 2009;46(4):339-50.
Hershko, C., & Skikne, B. (2009). Pathogenesis and management of iron deficiency anemia: emerging role of celiac disease, helicobacter pylori, and autoimmune gastritis. Seminars in Hematology, 46(4), 339-50. https://doi.org/10.1053/j.seminhematol.2009.06.002
Hershko C, Skikne B. Pathogenesis and Management of Iron Deficiency Anemia: Emerging Role of Celiac Disease, Helicobacter Pylori, and Autoimmune Gastritis. Semin Hematol. 2009;46(4):339-50. PubMed PMID: 19786202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pathogenesis and management of iron deficiency anemia: emerging role of celiac disease, helicobacter pylori, and autoimmune gastritis. AU - Hershko,Chaim, AU - Skikne,Barry, PY - 2009/9/30/entrez PY - 2009/9/30/pubmed PY - 2009/11/6/medline SP - 339 EP - 50 JF - Seminars in hematology JO - Semin Hematol VL - 46 IS - 4 N2 - The causes of iron deficiency vary significantly during different stages of life, and according to gender and socioeconomic circumstances. Although dietary iron is important, iron deficiency anemia (IDA) is mostly attributed to blood loss and may be the presenting clinical feature of occult bleeding from the gastrointestinal (GI) tract heralding underlying malignancy. Conventional GI diagnostic workup fails to establish the cause of iron deficiency in about one third of patients. However, abnormal iron absorption caused by hereditary iron-refractory iron deficiency anemia (IRIDA) or acquired disease is increasingly recognized as an important cause of unexplained iron deficiency. The recent availability of convenient, non-invasive screening methods to identify celiac disease, autoimmune atrophic gastritis and Helicobacter pylori infection has greatly facilitated the recognition of patients with these entities. Cure of previously refractory IDA by H pylori eradication provides strong evidence supporting a cause-and-effect relation. The intriguing recent observations of H pylori antibodies directed against epitopes on gastric mucosal cells in atrophic gastritis imply an autoimmune mechanism triggered by H pylori and directed against gastric parietal cells by means of antigenic mimicry. Improved understanding of the role of abnormal iron absorption in IDA has important implications for current concepts related to the pathogenesis and management of IDA. SN - 0037-1963 UR - https://www.unboundmedicine.com/medline/citation/19786202/Pathogenesis_and_management_of_iron_deficiency_anemia:_emerging_role_of_celiac_disease_helicobacter_pylori_and_autoimmune_gastritis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0037-1963(09)00099-7 DB - PRIME DP - Unbound Medicine ER -