Iron deficiency anemia(IDA)continues to be a global public health problem.Oral iron is the universally accepted first-line therapy,and most children have a prompt and favorable response to oral formulations.In subsets...Iron deficiency anemia(IDA)continues to be a global public health problem.Oral iron is the universally accepted first-line therapy,and most children have a prompt and favorable response to oral formulations.In subsets of children who fail to respond due to intolerance,poor adherence,or inadequate intestinal absorption,parenteral iron is indicated.Despite numerous studies in adults with IDA of diverse etiologies,pediatric studies on parenteral iron use are very limited.Although mostly retrospective and small,these studies have documented the efficacy and safety profile of intravenous iron formulations.In this editorial the author comments on the most important published data and underscores the need to seriously consider parenteral iron use in children unresponsive to oral therapy.展开更多
BACKGROUND Screening for iron deficiency anemia(IDA)is important in managing pediatric patients with inflammatory bowel disease(IBD).Concerns related to adverse reactions may contribute to a reluctance to prescribe in...BACKGROUND Screening for iron deficiency anemia(IDA)is important in managing pediatric patients with inflammatory bowel disease(IBD).Concerns related to adverse reactions may contribute to a reluctance to prescribe intravenous(IV)iron to treat IDA in this population.AIM To track the efficacy and safety of IV iron therapy in treating IDA in pediatric IBD patients admitted to our center.METHODS A longitudinal observational cohort study was performed on 236 consecutive pediatric patients admitted to our tertiary IBD care center between September 2017 and December 2019.92 patients met study criteria for IDA,of which 57 received IV iron,17 received oral iron,and 18 were discharged prior to receiving iron therapy.RESULTS Patients treated with IV iron during their hospitalization experienced a significant increase of 1.9(±0.2)g/dL in mean(±SE)hemoglobin(Hb)concentration by the first ambulatory follow-up,compared to patients who received oral iron 0.8(±0.3)g/dL or no iron 0.8(±0.3)g/dL(P=0.03).One out of 57(1.8%)patients that received IV iron therapy experienced an adverse reaction.CONCLUSION Our findings demonstrate that treatment with IV iron therapy is safe and efficacious in improving Hb and iron levels in pediatric patients with IDA and active IBD.展开更多
Iron deficiency anemia(IDA)is a common nutritional problem, but traditional iron supplements cause many adverse reactions. Thus, the development of a novel iron supplement might be significant for the treatment of IDA...Iron deficiency anemia(IDA)is a common nutritional problem, but traditional iron supplements cause many adverse reactions. Thus, the development of a novel iron supplement might be significant for the treatment of IDA. This study aimed to study the transport mechanism of Flammulina velutipes polysaccharide-iron complex(FVP1-Fe(Ⅲ))in Caco-2 cells and the therapeutic effect on IDA rats, as well as the influence on gut microbiota in vivo. These results showed that in vitro, the uptake of FVP1-Fe(Ⅲ)was mediated by sodium-dependent glucose transporter-1(SGLT1)and facilitated glucose transporter-2(GLUT2)and GLUT2 played a dominant function. The multidrug resistance-associated protein-2(MRP-2)was involved in the efflux of FVP1-Fe(Ⅲ)across the Caco-2 cells. In vivo, FVP1-Fe(Ⅲ)had a better restorative effect on blood parameters and iron status indicators in rats with IDA as compared with FeSO_4 and exerted this effect by downregulating the expression of hepcidin. FVP1-Fe(Ⅲ)could also regulate gut microbiota dysbiosis in iron deficiency rats by returning the relative abundance of gut microbiota to the normal level. Besides, as a dietary factor, vitamin C(vit C)could enhance the therapeutic effect of FVP1-Fe(Ⅲ). These present findings showed that FVP1-Fe(Ⅲ)could be exploited as a novel iron supplement to treat IDA.展开更多
BACKGROUND Iron deficiency anemia(IDA)and thalassemia trait(TT)are the most common microcytic and hypochromic anemias.Differentiation between mild TT and early IDA is still a clinical challenge.AIM To develop and vali...BACKGROUND Iron deficiency anemia(IDA)and thalassemia trait(TT)are the most common microcytic and hypochromic anemias.Differentiation between mild TT and early IDA is still a clinical challenge.AIM To develop and validate a new index for discriminating between IDA and TT.METHODS Blood count data from 126 patients,consisting of 43 TT patients and 83 IDA pa-tients,was retrospectively analyzed to develop a new index formula.This formula was further validated in another 61 patients,consisting of 48 TT patients and 13 IDA patients.RESULTS The new index is the ratio of hemoglobin to mean corpuscular volume.Its sen-sitivity,specificity,accuracy,Youden’s Index,area under the receiver operating characteristic curve,and Kappa coefficient in discriminating between IDA and TT were 93.5%,78.4%,83.3%,0.72,0.97,and 0.65,respectively.CONCLUSION This new index has good diagnostic performance in discriminating between mild TT and early IDA.It requires only two results of complete blood count,which can be a very desirable feature in under-resourced scenarios.展开更多
Background: Anemia is one of the most prevalent complications during pregnancy. It is commonly considered a risk factor for poor pregnancy outcomes and can result in complications that threaten the life of both mother...Background: Anemia is one of the most prevalent complications during pregnancy. It is commonly considered a risk factor for poor pregnancy outcomes and can result in complications that threaten the life of both mother and fetus, such as preterm birth, and low birth weight. There is clear evidence to support prompt treatment in all patients with iron deficiency anemia because it is known that treatment improves quality of life and physical condition as well as alleviates fatigue and cognitive deficits. Objective: The aim of the study was to evaluate the value of addition of vitamin B6 to iron in treatment of iron deficiency anemia in pregnant women during the second trimester. Patients and Methods: The study was done by giving anemia pregnant women iron therapy and vitamin B6 which represent group A and iron therapy alone which represents group B. For each pregnant woman, age, parity and gestational history were taken before treatment. All pregnant women took their allocated treatment regularly for three weeks after diagnosis of iron deficiency anemia with complete blood picture and followed up after three weeks. Results: Results of the study revealed that there was no statistically significant difference between the two groups of therapy according to the hemoglobin level before treatment (p-value = 0.734), statistically significant higher mean value in after treatment than before treatment (p-value = 0.048), there was a significant difference in the rate of change of hemoglobin (p-value = 0.011) and body mass index (p-value 0.001). Conclusion: Iron and vitamin B6 seems to increase hemoglobin level more than iron only. Thus, in pregnant women with iron deficiency anemia iron plus vitamin B6 may be considered as a more effective alternative treatment than iron only.展开更多
Iron deficiency anemia(IDA)is common and often under recognized problem in the elderly.It may be the result of multiple factors including a bleeding lesion in the gastrointestinal tract.Twenty percent of elderly patie...Iron deficiency anemia(IDA)is common and often under recognized problem in the elderly.It may be the result of multiple factors including a bleeding lesion in the gastrointestinal tract.Twenty percent of elderly patients with IDA have a negative upper and lower endoscopy and two-thirds of these have a lesion in the small bowel(SB).Capsule endoscopy(CE)provides direct visualization of entire SB mucosa,which was not possible before.It is superior to push enteroscopy,enteroclysis and barium radiography for diagnosing clinically significant SB pathology resulting in IDA.Angioectasia is one of the commonest lesions seen on the CE in elderly with IDA.The diagnostic yield of CE for IDA progressively increases with advancing age,and is highest among patients over 85 years of age.Balloon assisted enteroscopy is used to treat the lesions seen on CE.CE has some limitations mainly lack of therapeutic capability,inability to provide precise location of the lesion and false positive results.Overall CE is a very safe and effective procedure for the evaluation of IDA in elderly.展开更多
Iron deficiency （ID）, with or without anemia, is often caused by digestive diseases and should always be investigated, except in very specific situations, as its causes could be serious diseases, such as cancer. Dia...Iron deficiency （ID）, with or without anemia, is often caused by digestive diseases and should always be investigated, except in very specific situations, as its causes could be serious diseases, such as cancer. Diagnosis of ID is not always easy. Low serum levels of ferritin or transferrin saturation, imply a situation of absolute or functional ID. It is sometimes difficult to differentiate ID anemia from anemia of chronic diseases, which can coexist. In this case, other parameters, such as soluble transferrin receptor activity can be very useful. After an initial evaluation by clinical history, urine analysis, and serological tests for celiac disease, gastroscopy and colonoscopy are the key diagnostic tools for investigating the origin of ID, and will detect the most important and prevalent diseases. If both tests are normal and anemia is not severe, treatment with oral iron can be indicated, along with stopping any treatment with non-steroidal anti-inflammatory drugs. In the absence of response to oral iron, or if the anemia is severe or clinical suspicion of important disease persists, we must insist on diagnostic evaluation. Repeat endoscopic studies should be considered in many cases and if both still show normal results, investigating the small bowel must be considered. The main techniques in this case are capsule endoscopy, followed by展开更多
AIM： To elucidate the influences of Hpylori infection on oral iron treatment for iron deficiency anemia （IDA）.METHODS： A total of 86 patients were divided into two groups： group A, receiving ferrous succinate com...AIM： To elucidate the influences of Hpylori infection on oral iron treatment for iron deficiency anemia （IDA）.METHODS： A total of 86 patients were divided into two groups： group A, receiving ferrous succinate combined with triple therapy for H pylori eradication, and group B （control）, treated with ferrous succinate only. During treatment of IDA, dynamic changes in hemoglobin （Hb） level, mean corpuscular volume （MCV）, mean corpuscular hemoglobin （MCH）, serum iron （SI）, and serum ferritin （SF） were compared between the groups.RESULTS： Hb was slightly higher in group A at d 14 alter the start of triple therapy for H pylori eradication （P 〉 0.05）. After the therapy, the increase of Hb in group A became significantly faster than that in group B （P 〈 0.05）. At d 56, the mean Hb in group A returned to the normal level, however, in group B, it was lower than that in group A （P 〈 0.05） although it had also increased compared with that before oral iron treatment. The MCV and MCH in group A recovered to the normal level, and were much higher than those in group B （P 〈 0.05） at d 21. In Group B, the MCV and MCH remained at lower than normal levels until d 42 alter the start of therapy. And then, they reached a plateau in both groups and the differences disappeared （P 〉 0.05）. The SF in group A was higher than that in group B （P 〈 0.05） 28 d alter the treatment and its improvement was quicker in group A （P 〈 0.05）, and the difference between the two groups was even more significant （P 〈 0.01） at d 56. The SI in group A was higher than that in group B （P 〈 0.05） at d 14 and this persisted until d 56 when the follow-up of this research was finished.CONCLUSION： Treatment of H pylori can enhance the efficacy of ferrous succinate therapy in IDA patients with Hpylori-positive chronic gastritis.展开更多
Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure.Methods: Guinea pigs mo...Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure.Methods: Guinea pigs model of iron deficiency anemia complicated with chronic heart failure in 10 guinea pigs of the experimental group was made by feeding a low iron diet,pure water and subcutaneous injection of isoproterenol. The control group consisting of 11 guinea pigs was given normal food, normal water and injected with normal saline. The left ventricular outflow tract model specimen was also prepared. The standard microelectrode technique was used to observe electrophysiological changes of autonomic cells in the outflow tract of left ventricular heart failure complicated with iron deficiency anemia in guinea pig model. The indicators of observation were maximal diastolic potential, action potential amplitude, 0 phase maximal depolarization velocity, 4 phase automatic depolarization velocity, repolarization 50% and 90%, and spontaneous discharge frequency.Results: Compared with the control group, 4 phase automatic depolarization velocity,spontaneous discharge frequency and 0 phase maximal depolarization velocity decreased significantly(P < 0.01) and action potential amplitude reduced(P < 0.01) in model group. Moreover, repolarization 50% and 90% increased(P < 0.01).Conclusions: There are electrophysiological abnormalities of the left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with heart failure.展开更多
AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obs...AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obscure origin were screened for GSE. Anti- endomysial antibody (EMA) and tissue transglutamin- ase antibody (tTG) levels were evaluated and duodenal biopsies were taken and scored according to the Marsh classification. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histol- ogy. Gluten free diet (GFD) was advised for all the GSE patients. RESULTS: Of the 4120 IDA patients referred to our Hematology departments, 206 (95 male) patients were found to have IDA of obscure origin. Thirty out of 206 patients (14.6%) had GSE. The mean age of GSE pa- tients was 34.6 ± 17.03 (range 10-72 years). The female to male ratio was 1.3:1. Sixteen patients had Marsh 3,12 had Marsh 2, and 2 had Marsh 1 lesions. The sever- ity of anemia was in parallel with the severity of duode- nal lesions. Twenty-two GSE patients (73.3%) had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels (Hb) increased from 9.9 ± 1.6 to 12.8 ± 1.0 g/dL (P < 0.01). Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions (e.g. no villous atrophy) on duodenal biopsy, mean Hb increased from 11.0 ± 1.1 to 13.1 ± 1.0 g/dL (P < 0.01) while they did not receive any iron supplementation. CONCLUSION: There is a high prevalence (e.g. 14.6%) of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.展开更多
Oral iron supplements such as ferrous iron salts are major treatment agents for iron deficiency anemia(IDA)due to the convenience of large dose administration and good patient compliance.However,the gastrointestinal a...Oral iron supplements such as ferrous iron salts are major treatment agents for iron deficiency anemia(IDA)due to the convenience of large dose administration and good patient compliance.However,the gastrointestinal adverse impact caused by Fe2+stimulus and low bioavailability severely impedes its therapeutic effects.In recent years,it has been found that nano iron⁃based nanoparticles with high surface⁃to⁃volume ratio and low iron ion leakage can alleviate the toxic effect and improve the gastrointestinal absorbance.For further clinical development,nano materials need to meet the pharmaceutical quality demand.Carboxymethyl cellulose(CMC)is a significant pharmaceutical ingredient applied in approved drug formulations,and polyglucosorbitol carboxymethylether(PSC)has been utilized in iron⁃based nanomedicine ferumoxytol synthesis,both of which can be firmly anchored on iron oxide by carboxyl chelation.In this work,iron oxide nanoparticles(NPs)modified with CMC were designed and synthesized,and the structure composition and physicochemical properties were distinctly characterized.Oral supplement effects on rat IDA were investigated and compared with other recently reported iron supplements including NPs modified with PSC.Results show that the oral nano iron supplement achieved the recovery of hemoglobin and serum iron level in only two weeks with high safety.The nano iron oxide modified with pharmaceutical excipients provides new potential approach for oral iron supplement available in clinics.展开更多
AIM: To characterize clinical, laboratorial, and histological profile of pediatric autoimmune gastritis in the setting of unexplained iron deficiency anemia investigation.
There is ample clinical evidence suggesting that the presence of large axial or paraesophageal hernias may lead to iron deficiency anemia.So-called Cameron lesions,as well as other small mucosa erosions,in the sliding...There is ample clinical evidence suggesting that the presence of large axial or paraesophageal hernias may lead to iron deficiency anemia.So-called Cameron lesions,as well as other small mucosa erosions,in the sliding area of these diaphragmatic hernias lead to invisible chronic blood loss and consequently to iron depletion.While the spectrum of symptoms in these patients is large,anemia is often not the only indication and typically not the primary indication for surgical correction of diaphragmatic hernias.Drug treatment with proton pump inhibitors and iron substitution can alleviate anemia,but this is not always successful.To exclude other possible bleeding sources in the gastrointestinal tract,a comprehensive diagnostic program is necessary and reviewed in this manuscript.Additionally,we discuss controversies in the surgical management of paraesophageal hernias.展开更多
<b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:Verdana;">It is estimated that about 18% of pregnant women suffer from iron def...<b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:Verdana;">It is estimated that about 18% of pregnant women suffer from iron deficiency anemia throughout their whole pregnancy.</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">In </span><span style="font-family:Verdana;">twin</span><span style="font-family:Verdana;"> pregnancy, owing to the relatively greater </span><span style="font-family:Verdana;">feto-placental</span><span style="font-family:Verdana;"> requirements and greater expansion in maternal plasma volume </span></span><span style="font-family:Verdana;">and red cell mass, iron requirements </span><span style="font-family:""><span style="font-family:Verdana;">are magnified 1.8 times compared to singleton pregnancies. However, for </span><span style="font-family:Verdana;">prevention</span><span style="font-family:Verdana;"> of iron deficiency in twin </span><span style="font-family:Verdana;">pregnancy</span><span style="font-family:Verdana;">, only sparse data exist regarding the sufficiency of the standard antenatal iron supplementation dose used in singleton pregnancies to meet the increased iron demand. In this study, we investigate the effect of single and double dose iron supplementation for </span><span style="font-family:Verdana;">prevention</span><span style="font-family:Verdana;"> of iron deficiency anemia in twin pregnancy. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A randomized controlled clinical trial was conducted at our center in the period between February 2019 and October 2020,</span></span><span style="font-family:Verdana;"> and</span><span style="font-family:""> <span style="font-family:Verdana;">included</span><span style="font-family:Verdana;"> 450 eligible healthy non-anemic women aged 18 </span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 35 years, with twin pregnancy at 12 </span><span style="font-family:Verdana;">-</span><span style="font-family:""><span style="font-family:Verdana;"> 16 weeks of gestation. After informed consent, eligible women were randomized to receive either single dose 27 mg, or double dose 54 mg elemental iron supplementation. Monitoring of hemoglobin concentration was done at fixed time points during gestation: at enrollment, 24 weeks, 32 weeks </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> before delivery. The primary outcome of the study was the incidence of iron deficiency anemia during </span><span style="font-family:Verdana;">follow up</span><span style="font-family:Verdana;"> until delivery. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The incidence of iron deficiency anemia in the two groups did not differ significantly between the </span><span style="font-family:Verdana;">single dose</span><span style="font-family:Verdana;"> group (19.1%) and the double dose group (24.0%). In women who did not develop Iron Deficiency Anemia, hemoglobin concentration varied significantly along the different gestational ages during the </span><span style="font-family:Verdana;">follow up</span><span style="font-family:Verdana;"> pe</span><span><span style="font-family:Verdana;">riod. In contrast, they did not show </span><span style="font-family:Verdana;">an overall statistically significant difference</span></span><span style="font-family:Verdana;"> in the hemoglobin concentrations between the single or double dose groups. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> <span style="font-family:Verdana;">This</span><span style="font-family:Verdana;"> clinical trial did not demonstrate an added benefit for doubling prophylactic iron supplementation dose in non-anemic women with </span><span style="font-family:Verdana;">twin</span><span style="font-family:Verdana;"> pregnancy.展开更多
BACKGROUND Iron deficiency anemia has a worldwide impact on individual health and national and international economies,with an estimated one-third of the world population being iron deficient.AIM To evaluate the iron ...BACKGROUND Iron deficiency anemia has a worldwide impact on individual health and national and international economies,with an estimated one-third of the world population being iron deficient.AIM To evaluate the iron deficiency literature published between 2001-2020 with an emphasis on:(1)Identification of collaborative research networks most active in this field;(2)Research topics of greatest importance;and(3)Analysis of the mostcited papers published between 2001-2020 and the most cited papers in 5-year intervals during this period to assess for emerging trends in research in this area.METHODS A search of Clarivate Analytics World of Science Core Collection was performed for the topic“iron deficiency anemia”,limited to document type(article or review),language(English),and time span(2001-2020).The following data were extracted from these articles:Year of publication,journal,study design,country of first author,and number of citations.The metadata derived from the search were used to identify publication trends in iron deficiency anemia research and their distribution in countries/regions and institutions.Network visualization by VOSviewer(Leiden University)was performed to identify international collaborative groups and research hotspots.RESULTS The search identified 4828 publications.Three international collaborative networks were identified:United States,Canada,and India;Turkey,China,and Japan;and England and other European countries.Five research areas were hotspots:Epidemiologic aspects of iron deficiency anemia,biochemical aspects of iron deficiency anemia,clinical evaluation of causes of iron deficiency anemia,causes of iron deficiency anemia,and bioavailability of dietary iron.Subset analysis of the top-10 overall cited papers,and the top-10 cited papers for each 5-year increment beginning in 2001 showed that the largest number of highly cited papers were from the field of epidemiology,the smallest number from the field of bioavailability of dietary iron.CONCLUSION The literature on iron deficiency anemia has a high citation rate compared to studies of other topics using similar methodology and is heavily biased toward studies from the United States and epidemiologic studies.展开更多
We report a clinical case of a 21-year-old patient with iron deficiency anemia related to <em>Helicobacter pylori</em> (<em>H. pylori</em>) infection. The pan gastritis due to <em>H. pylo...We report a clinical case of a 21-year-old patient with iron deficiency anemia related to <em>Helicobacter pylori</em> (<em>H. pylori</em>) infection. The pan gastritis due to <em>H. pylori </em>and an unexplained iron deficiency anemia has recently been proposed although still discussed. Among the possible causes the role played by this bacterium remains controversial. The diagnosis had been mentioned in view of the recurrence of anemia and confirmed by endoscopic biopsy. Anemia was corrected by iron supplementation associated with a specific treatment of this germ.展开更多
To evaluate the adequacy of the study of iron deficiency anemia (IDA) in real life practice prior to referral to a gastroenterology department for small bowel evaluation. METHODSAll consecutive patients referred to a ...To evaluate the adequacy of the study of iron deficiency anemia (IDA) in real life practice prior to referral to a gastroenterology department for small bowel evaluation. METHODSAll consecutive patients referred to a gastroenterology department for small bowel investigation due to iron deficiency anemia, between January 2013 and December 2015 were included. Both patients referred from general practitioners or directly from different hospital departments were selected. Relevant clinical information regarding prior anemia workup was retrospectively collected from medical records. An appropriate pre-referral study was considered the execution of esophagogastroduodenoscopy (EGD) with Helicobacter pylori (H. pylori) investigation, colonoscopy with quality standards (recent, total and with adequate preparation) and celiac disease (CD) screening (through serologic testing and/or histopathological investigation). RESULTSA total of 77 patients (58.4% female, mean age 67.1 ± 16.7 years) were included. Most (53.2%) patients were referred from general practitioners, 41.6% from other hospital specialties and 5.2% directly from the emergency department. The mean pre-referral hemoglobin concentration was 8.8 ± 2.0 g/dL and the majority of anemias had microcytic (71.4%) and hypochromic (72.7%) characteristics. 77.9% of patients presented with an incomplete pre-referral study: EGD in 97.4%, with H. pylori investigation in 58.3%, colonoscopy with quality criteria in 63.6%, and CD screening in 24.7%. Patients with an appropriate study at the time of referral were younger (48.7 ± 17.7 vs 72.3 ± 12.3 years, P < 0.001). Small bowel evaluation was ultimately undertaken in 72.7% of patients, with a more frequent evaluation in patients with a quality colonoscopy at referral (78.6% vs 23.8%); P < 0.001 (OR = 11.7, 95%CI: 3.6-38.6). The most common diagnosis regarded as the likely cause of IDA was small bowel angioectasia (18.2%) but additional causes were also found in the upper and lower gastrointestinal tracts of near 20% of patients. Small bowel studies detected previously unknown non-small bowel findings in 7.7% of patients. CONCLUSIONThe study of anemia prior to referral to gastroenterology department is unsatisfactory. Only approximately a quarter of patients presented with an appropriate study.展开更多
[Objectives]This study was conducted to observe the effect of Lujingyiqishengxue Pill on iron metabolism in rats with iron deficiency anemia. [Methods] The iron-deficiency anemia rat model was established by feeding l...[Objectives]This study was conducted to observe the effect of Lujingyiqishengxue Pill on iron metabolism in rats with iron deficiency anemia. [Methods] The iron-deficiency anemia rat model was established by feeding low-iron diet. Meanwhile, the rats were given oral gavage of ferrous succinate(0.036 g/kg, positive drug group) and Lujingyiqishengxue Pill(4.4, 2.2, 1.1 g/kg, high, middle and low dose groups), once daily for 42 consecutive days. The body weight of the rats was observed every week, and the peripheral blood[red blood cells(RBC), hemoglobin(HGB), and hematocrit(HCT)]and the iron contents in tissues(the liver, spleen, small intestine, kidney) of the rats were detected after modeling;and serum iron(SI), serum total iron binding capacity(TIBC), transferrin saturation(TSAT), serum ferritin(SF) and serum transferrin receptor 1(TFR1) and other iron metabolism indexes were determined. [Results] Compared with the model group, the high-dose Lujingyiqishengxue Pill significantly reversed the peripheral blood(HGB, HCT) and iron contents of various tissues(the liver, spleen, small intestine, kidney) in rats(P<0.01), and significantly increased SI, TSAT, SF(P<0.01), while the contents of TIBC and TFR1 were significantly decreased(P<0.01). [Conclusions] Lujingyiqishengxue Pill can significantly improve anemia and regulate iron metabolism in rats with iron-deficiency anemia, which provides a pharmacological reference for the clinical application of Lujingyiqishengxue Pill.展开更多
[Objectives]The research aimed to make a retrospective analysis and summary on the efficacy of Jianpi Shengxue Tablet in the treatment of iron deficiency anemia.[Methods]A total of 200 patients with iron deficiency an...[Objectives]The research aimed to make a retrospective analysis and summary on the efficacy of Jianpi Shengxue Tablet in the treatment of iron deficiency anemia.[Methods]A total of 200 patients with iron deficiency anemia who were treated at outpatient in Tongzhou District of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 1,2017 to October 30,2020 were selected as the research objects.All these patients were given treatment with Jianpi Shengxue Tablet for the first time.Results of blood routine examination,serum iron concentration,total iron binding capacity and ferritin were compared before and after treatment at different dates.Subjective symptoms and adverse reactions were also described.Jianpi Shengxue Tablet was given orally after meals,3 tablets each time,3 times a day.[Results]Hemoglobin level was(83.58±15.81)g/L(M±SD,n=200)before treatment,and(103.40±12.60)g/L(n=74)after 2 week's treatment,with a 24.3%increase(P=0.0047).Hemoglobin concentration was(111.9±19.4)g/L(n=47)at the 4th week after treatment,which was near normality;(126.0±9.49)g/L(n=30)at the 6th week with complete normality and(130.7±7.95)g/L(n=23)at the 8th week.MCV,MCH and MCHC increased gradually after treatment.Serum total iron biding capacity decreased,while serum iron and ferritin increased gradually,and the three indexes were significantly different at the 4th week after treatment as compared with those before treatment(P﹤0.01).Subjective symptoms were improved in the 1st week from starting treatment among all the cases.The adverse events were mainly gastrointestinal irritation,occurring in 7/200 cases(3.5%).[Conclusions]Jianpi Shengxue Tablet is quite effective and safe in the treatment of iron deficiency anemia,with rapid comprehensive improvement of anemia-related symptoms and increase of hemoglobin and red blood cell parameters.展开更多
文摘Iron deficiency anemia(IDA)continues to be a global public health problem.Oral iron is the universally accepted first-line therapy,and most children have a prompt and favorable response to oral formulations.In subsets of children who fail to respond due to intolerance,poor adherence,or inadequate intestinal absorption,parenteral iron is indicated.Despite numerous studies in adults with IDA of diverse etiologies,pediatric studies on parenteral iron use are very limited.Although mostly retrospective and small,these studies have documented the efficacy and safety profile of intravenous iron formulations.In this editorial the author comments on the most important published data and underscores the need to seriously consider parenteral iron use in children unresponsive to oral therapy.
文摘BACKGROUND Screening for iron deficiency anemia(IDA)is important in managing pediatric patients with inflammatory bowel disease(IBD).Concerns related to adverse reactions may contribute to a reluctance to prescribe intravenous(IV)iron to treat IDA in this population.AIM To track the efficacy and safety of IV iron therapy in treating IDA in pediatric IBD patients admitted to our center.METHODS A longitudinal observational cohort study was performed on 236 consecutive pediatric patients admitted to our tertiary IBD care center between September 2017 and December 2019.92 patients met study criteria for IDA,of which 57 received IV iron,17 received oral iron,and 18 were discharged prior to receiving iron therapy.RESULTS Patients treated with IV iron during their hospitalization experienced a significant increase of 1.9(±0.2)g/dL in mean(±SE)hemoglobin(Hb)concentration by the first ambulatory follow-up,compared to patients who received oral iron 0.8(±0.3)g/dL or no iron 0.8(±0.3)g/dL(P=0.03).One out of 57(1.8%)patients that received IV iron therapy experienced an adverse reaction.CONCLUSION Our findings demonstrate that treatment with IV iron therapy is safe and efficacious in improving Hb and iron levels in pediatric patients with IDA and active IBD.
基金supported by the State key research and development plan “Modern food processing and food storage and transportation technology and equipment” (2017YFD0400203)。
文摘Iron deficiency anemia(IDA)is a common nutritional problem, but traditional iron supplements cause many adverse reactions. Thus, the development of a novel iron supplement might be significant for the treatment of IDA. This study aimed to study the transport mechanism of Flammulina velutipes polysaccharide-iron complex(FVP1-Fe(Ⅲ))in Caco-2 cells and the therapeutic effect on IDA rats, as well as the influence on gut microbiota in vivo. These results showed that in vitro, the uptake of FVP1-Fe(Ⅲ)was mediated by sodium-dependent glucose transporter-1(SGLT1)and facilitated glucose transporter-2(GLUT2)and GLUT2 played a dominant function. The multidrug resistance-associated protein-2(MRP-2)was involved in the efflux of FVP1-Fe(Ⅲ)across the Caco-2 cells. In vivo, FVP1-Fe(Ⅲ)had a better restorative effect on blood parameters and iron status indicators in rats with IDA as compared with FeSO_4 and exerted this effect by downregulating the expression of hepcidin. FVP1-Fe(Ⅲ)could also regulate gut microbiota dysbiosis in iron deficiency rats by returning the relative abundance of gut microbiota to the normal level. Besides, as a dietary factor, vitamin C(vit C)could enhance the therapeutic effect of FVP1-Fe(Ⅲ). These present findings showed that FVP1-Fe(Ⅲ)could be exploited as a novel iron supplement to treat IDA.
基金The study was reviewed and approved by the Shanghai Tenth People’s Hospital Institutional Review Board(Approval No.23K190).
文摘BACKGROUND Iron deficiency anemia(IDA)and thalassemia trait(TT)are the most common microcytic and hypochromic anemias.Differentiation between mild TT and early IDA is still a clinical challenge.AIM To develop and validate a new index for discriminating between IDA and TT.METHODS Blood count data from 126 patients,consisting of 43 TT patients and 83 IDA pa-tients,was retrospectively analyzed to develop a new index formula.This formula was further validated in another 61 patients,consisting of 48 TT patients and 13 IDA patients.RESULTS The new index is the ratio of hemoglobin to mean corpuscular volume.Its sen-sitivity,specificity,accuracy,Youden’s Index,area under the receiver operating characteristic curve,and Kappa coefficient in discriminating between IDA and TT were 93.5%,78.4%,83.3%,0.72,0.97,and 0.65,respectively.CONCLUSION This new index has good diagnostic performance in discriminating between mild TT and early IDA.It requires only two results of complete blood count,which can be a very desirable feature in under-resourced scenarios.
文摘Background: Anemia is one of the most prevalent complications during pregnancy. It is commonly considered a risk factor for poor pregnancy outcomes and can result in complications that threaten the life of both mother and fetus, such as preterm birth, and low birth weight. There is clear evidence to support prompt treatment in all patients with iron deficiency anemia because it is known that treatment improves quality of life and physical condition as well as alleviates fatigue and cognitive deficits. Objective: The aim of the study was to evaluate the value of addition of vitamin B6 to iron in treatment of iron deficiency anemia in pregnant women during the second trimester. Patients and Methods: The study was done by giving anemia pregnant women iron therapy and vitamin B6 which represent group A and iron therapy alone which represents group B. For each pregnant woman, age, parity and gestational history were taken before treatment. All pregnant women took their allocated treatment regularly for three weeks after diagnosis of iron deficiency anemia with complete blood picture and followed up after three weeks. Results: Results of the study revealed that there was no statistically significant difference between the two groups of therapy according to the hemoglobin level before treatment (p-value = 0.734), statistically significant higher mean value in after treatment than before treatment (p-value = 0.048), there was a significant difference in the rate of change of hemoglobin (p-value = 0.011) and body mass index (p-value 0.001). Conclusion: Iron and vitamin B6 seems to increase hemoglobin level more than iron only. Thus, in pregnant women with iron deficiency anemia iron plus vitamin B6 may be considered as a more effective alternative treatment than iron only.
文摘Iron deficiency anemia(IDA)is common and often under recognized problem in the elderly.It may be the result of multiple factors including a bleeding lesion in the gastrointestinal tract.Twenty percent of elderly patients with IDA have a negative upper and lower endoscopy and two-thirds of these have a lesion in the small bowel(SB).Capsule endoscopy(CE)provides direct visualization of entire SB mucosa,which was not possible before.It is superior to push enteroscopy,enteroclysis and barium radiography for diagnosing clinically significant SB pathology resulting in IDA.Angioectasia is one of the commonest lesions seen on the CE in elderly with IDA.The diagnostic yield of CE for IDA progressively increases with advancing age,and is highest among patients over 85 years of age.Balloon assisted enteroscopy is used to treat the lesions seen on CE.CE has some limitations mainly lack of therapeutic capability,inability to provide precise location of the lesion and false positive results.Overall CE is a very safe and effective procedure for the evaluation of IDA in elderly.
文摘Iron deficiency （ID）, with or without anemia, is often caused by digestive diseases and should always be investigated, except in very specific situations, as its causes could be serious diseases, such as cancer. Diagnosis of ID is not always easy. Low serum levels of ferritin or transferrin saturation, imply a situation of absolute or functional ID. It is sometimes difficult to differentiate ID anemia from anemia of chronic diseases, which can coexist. In this case, other parameters, such as soluble transferrin receptor activity can be very useful. After an initial evaluation by clinical history, urine analysis, and serological tests for celiac disease, gastroscopy and colonoscopy are the key diagnostic tools for investigating the origin of ID, and will detect the most important and prevalent diseases. If both tests are normal and anemia is not severe, treatment with oral iron can be indicated, along with stopping any treatment with non-steroidal anti-inflammatory drugs. In the absence of response to oral iron, or if the anemia is severe or clinical suspicion of important disease persists, we must insist on diagnostic evaluation. Repeat endoscopic studies should be considered in many cases and if both still show normal results, investigating the small bowel must be considered. The main techniques in this case are capsule endoscopy, followed by
文摘AIM： To elucidate the influences of Hpylori infection on oral iron treatment for iron deficiency anemia （IDA）.METHODS： A total of 86 patients were divided into two groups： group A, receiving ferrous succinate combined with triple therapy for H pylori eradication, and group B （control）, treated with ferrous succinate only. During treatment of IDA, dynamic changes in hemoglobin （Hb） level, mean corpuscular volume （MCV）, mean corpuscular hemoglobin （MCH）, serum iron （SI）, and serum ferritin （SF） were compared between the groups.RESULTS： Hb was slightly higher in group A at d 14 alter the start of triple therapy for H pylori eradication （P 〉 0.05）. After the therapy, the increase of Hb in group A became significantly faster than that in group B （P 〈 0.05）. At d 56, the mean Hb in group A returned to the normal level, however, in group B, it was lower than that in group A （P 〈 0.05） although it had also increased compared with that before oral iron treatment. The MCV and MCH in group A recovered to the normal level, and were much higher than those in group B （P 〈 0.05） at d 21. In Group B, the MCV and MCH remained at lower than normal levels until d 42 alter the start of therapy. And then, they reached a plateau in both groups and the differences disappeared （P 〉 0.05）. The SF in group A was higher than that in group B （P 〈 0.05） 28 d alter the treatment and its improvement was quicker in group A （P 〈 0.05）, and the difference between the two groups was even more significant （P 〈 0.01） at d 56. The SI in group A was higher than that in group B （P 〈 0.05） at d 14 and this persisted until d 56 when the follow-up of this research was finished.CONCLUSION： Treatment of H pylori can enhance the efficacy of ferrous succinate therapy in IDA patients with Hpylori-positive chronic gastritis.
基金supported by Zhangjiakou Project of Science and Technology Studies and Development Planning(Grand No.1321078D)
文摘Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure.Methods: Guinea pigs model of iron deficiency anemia complicated with chronic heart failure in 10 guinea pigs of the experimental group was made by feeding a low iron diet,pure water and subcutaneous injection of isoproterenol. The control group consisting of 11 guinea pigs was given normal food, normal water and injected with normal saline. The left ventricular outflow tract model specimen was also prepared. The standard microelectrode technique was used to observe electrophysiological changes of autonomic cells in the outflow tract of left ventricular heart failure complicated with iron deficiency anemia in guinea pig model. The indicators of observation were maximal diastolic potential, action potential amplitude, 0 phase maximal depolarization velocity, 4 phase automatic depolarization velocity, repolarization 50% and 90%, and spontaneous discharge frequency.Results: Compared with the control group, 4 phase automatic depolarization velocity,spontaneous discharge frequency and 0 phase maximal depolarization velocity decreased significantly(P < 0.01) and action potential amplitude reduced(P < 0.01) in model group. Moreover, repolarization 50% and 90% increased(P < 0.01).Conclusions: There are electrophysiological abnormalities of the left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with heart failure.
基金Supported by Local funds from Digestive Disease Research Centre, University of Tehran and Gastrointestinal and Liver Disease Research Centre, Iran University of Medical Science
文摘AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obscure origin were screened for GSE. Anti- endomysial antibody (EMA) and tissue transglutamin- ase antibody (tTG) levels were evaluated and duodenal biopsies were taken and scored according to the Marsh classification. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histol- ogy. Gluten free diet (GFD) was advised for all the GSE patients. RESULTS: Of the 4120 IDA patients referred to our Hematology departments, 206 (95 male) patients were found to have IDA of obscure origin. Thirty out of 206 patients (14.6%) had GSE. The mean age of GSE pa- tients was 34.6 ± 17.03 (range 10-72 years). The female to male ratio was 1.3:1. Sixteen patients had Marsh 3,12 had Marsh 2, and 2 had Marsh 1 lesions. The sever- ity of anemia was in parallel with the severity of duode- nal lesions. Twenty-two GSE patients (73.3%) had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels (Hb) increased from 9.9 ± 1.6 to 12.8 ± 1.0 g/dL (P < 0.01). Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions (e.g. no villous atrophy) on duodenal biopsy, mean Hb increased from 11.0 ± 1.1 to 13.1 ± 1.0 g/dL (P < 0.01) while they did not receive any iron supplementation. CONCLUSION: There is a high prevalence (e.g. 14.6%) of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.
基金National Key Research and Development Program of China(Grant No.2017YFA0104302)the National Natural Science Innovative Research Group Project(Grant No.61821002)+1 种基金the Natural Science Foundation of Jiangsu Province(Grant No.BK20190938)the Key Projects of the National Natural Science Foundation of China(Grant No.51832001).
文摘Oral iron supplements such as ferrous iron salts are major treatment agents for iron deficiency anemia(IDA)due to the convenience of large dose administration and good patient compliance.However,the gastrointestinal adverse impact caused by Fe2+stimulus and low bioavailability severely impedes its therapeutic effects.In recent years,it has been found that nano iron⁃based nanoparticles with high surface⁃to⁃volume ratio and low iron ion leakage can alleviate the toxic effect and improve the gastrointestinal absorbance.For further clinical development,nano materials need to meet the pharmaceutical quality demand.Carboxymethyl cellulose(CMC)is a significant pharmaceutical ingredient applied in approved drug formulations,and polyglucosorbitol carboxymethylether(PSC)has been utilized in iron⁃based nanomedicine ferumoxytol synthesis,both of which can be firmly anchored on iron oxide by carboxyl chelation.In this work,iron oxide nanoparticles(NPs)modified with CMC were designed and synthesized,and the structure composition and physicochemical properties were distinctly characterized.Oral supplement effects on rat IDA were investigated and compared with other recently reported iron supplements including NPs modified with PSC.Results show that the oral nano iron supplement achieved the recovery of hemoglobin and serum iron level in only two weeks with high safety.The nano iron oxide modified with pharmaceutical excipients provides new potential approach for oral iron supplement available in clinics.
文摘AIM: To characterize clinical, laboratorial, and histological profile of pediatric autoimmune gastritis in the setting of unexplained iron deficiency anemia investigation.
文摘There is ample clinical evidence suggesting that the presence of large axial or paraesophageal hernias may lead to iron deficiency anemia.So-called Cameron lesions,as well as other small mucosa erosions,in the sliding area of these diaphragmatic hernias lead to invisible chronic blood loss and consequently to iron depletion.While the spectrum of symptoms in these patients is large,anemia is often not the only indication and typically not the primary indication for surgical correction of diaphragmatic hernias.Drug treatment with proton pump inhibitors and iron substitution can alleviate anemia,but this is not always successful.To exclude other possible bleeding sources in the gastrointestinal tract,a comprehensive diagnostic program is necessary and reviewed in this manuscript.Additionally,we discuss controversies in the surgical management of paraesophageal hernias.
文摘<b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:Verdana;">It is estimated that about 18% of pregnant women suffer from iron deficiency anemia throughout their whole pregnancy.</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">In </span><span style="font-family:Verdana;">twin</span><span style="font-family:Verdana;"> pregnancy, owing to the relatively greater </span><span style="font-family:Verdana;">feto-placental</span><span style="font-family:Verdana;"> requirements and greater expansion in maternal plasma volume </span></span><span style="font-family:Verdana;">and red cell mass, iron requirements </span><span style="font-family:""><span style="font-family:Verdana;">are magnified 1.8 times compared to singleton pregnancies. However, for </span><span style="font-family:Verdana;">prevention</span><span style="font-family:Verdana;"> of iron deficiency in twin </span><span style="font-family:Verdana;">pregnancy</span><span style="font-family:Verdana;">, only sparse data exist regarding the sufficiency of the standard antenatal iron supplementation dose used in singleton pregnancies to meet the increased iron demand. In this study, we investigate the effect of single and double dose iron supplementation for </span><span style="font-family:Verdana;">prevention</span><span style="font-family:Verdana;"> of iron deficiency anemia in twin pregnancy. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A randomized controlled clinical trial was conducted at our center in the period between February 2019 and October 2020,</span></span><span style="font-family:Verdana;"> and</span><span style="font-family:""> <span style="font-family:Verdana;">included</span><span style="font-family:Verdana;"> 450 eligible healthy non-anemic women aged 18 </span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 35 years, with twin pregnancy at 12 </span><span style="font-family:Verdana;">-</span><span style="font-family:""><span style="font-family:Verdana;"> 16 weeks of gestation. After informed consent, eligible women were randomized to receive either single dose 27 mg, or double dose 54 mg elemental iron supplementation. Monitoring of hemoglobin concentration was done at fixed time points during gestation: at enrollment, 24 weeks, 32 weeks </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> before delivery. The primary outcome of the study was the incidence of iron deficiency anemia during </span><span style="font-family:Verdana;">follow up</span><span style="font-family:Verdana;"> until delivery. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The incidence of iron deficiency anemia in the two groups did not differ significantly between the </span><span style="font-family:Verdana;">single dose</span><span style="font-family:Verdana;"> group (19.1%) and the double dose group (24.0%). In women who did not develop Iron Deficiency Anemia, hemoglobin concentration varied significantly along the different gestational ages during the </span><span style="font-family:Verdana;">follow up</span><span style="font-family:Verdana;"> pe</span><span><span style="font-family:Verdana;">riod. In contrast, they did not show </span><span style="font-family:Verdana;">an overall statistically significant difference</span></span><span style="font-family:Verdana;"> in the hemoglobin concentrations between the single or double dose groups. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> <span style="font-family:Verdana;">This</span><span style="font-family:Verdana;"> clinical trial did not demonstrate an added benefit for doubling prophylactic iron supplementation dose in non-anemic women with </span><span style="font-family:Verdana;">twin</span><span style="font-family:Verdana;"> pregnancy.
文摘BACKGROUND Iron deficiency anemia has a worldwide impact on individual health and national and international economies,with an estimated one-third of the world population being iron deficient.AIM To evaluate the iron deficiency literature published between 2001-2020 with an emphasis on:(1)Identification of collaborative research networks most active in this field;(2)Research topics of greatest importance;and(3)Analysis of the mostcited papers published between 2001-2020 and the most cited papers in 5-year intervals during this period to assess for emerging trends in research in this area.METHODS A search of Clarivate Analytics World of Science Core Collection was performed for the topic“iron deficiency anemia”,limited to document type(article or review),language(English),and time span(2001-2020).The following data were extracted from these articles:Year of publication,journal,study design,country of first author,and number of citations.The metadata derived from the search were used to identify publication trends in iron deficiency anemia research and their distribution in countries/regions and institutions.Network visualization by VOSviewer(Leiden University)was performed to identify international collaborative groups and research hotspots.RESULTS The search identified 4828 publications.Three international collaborative networks were identified:United States,Canada,and India;Turkey,China,and Japan;and England and other European countries.Five research areas were hotspots:Epidemiologic aspects of iron deficiency anemia,biochemical aspects of iron deficiency anemia,clinical evaluation of causes of iron deficiency anemia,causes of iron deficiency anemia,and bioavailability of dietary iron.Subset analysis of the top-10 overall cited papers,and the top-10 cited papers for each 5-year increment beginning in 2001 showed that the largest number of highly cited papers were from the field of epidemiology,the smallest number from the field of bioavailability of dietary iron.CONCLUSION The literature on iron deficiency anemia has a high citation rate compared to studies of other topics using similar methodology and is heavily biased toward studies from the United States and epidemiologic studies.
文摘We report a clinical case of a 21-year-old patient with iron deficiency anemia related to <em>Helicobacter pylori</em> (<em>H. pylori</em>) infection. The pan gastritis due to <em>H. pylori </em>and an unexplained iron deficiency anemia has recently been proposed although still discussed. Among the possible causes the role played by this bacterium remains controversial. The diagnosis had been mentioned in view of the recurrence of anemia and confirmed by endoscopic biopsy. Anemia was corrected by iron supplementation associated with a specific treatment of this germ.
文摘To evaluate the adequacy of the study of iron deficiency anemia (IDA) in real life practice prior to referral to a gastroenterology department for small bowel evaluation. METHODSAll consecutive patients referred to a gastroenterology department for small bowel investigation due to iron deficiency anemia, between January 2013 and December 2015 were included. Both patients referred from general practitioners or directly from different hospital departments were selected. Relevant clinical information regarding prior anemia workup was retrospectively collected from medical records. An appropriate pre-referral study was considered the execution of esophagogastroduodenoscopy (EGD) with Helicobacter pylori (H. pylori) investigation, colonoscopy with quality standards (recent, total and with adequate preparation) and celiac disease (CD) screening (through serologic testing and/or histopathological investigation). RESULTSA total of 77 patients (58.4% female, mean age 67.1 ± 16.7 years) were included. Most (53.2%) patients were referred from general practitioners, 41.6% from other hospital specialties and 5.2% directly from the emergency department. The mean pre-referral hemoglobin concentration was 8.8 ± 2.0 g/dL and the majority of anemias had microcytic (71.4%) and hypochromic (72.7%) characteristics. 77.9% of patients presented with an incomplete pre-referral study: EGD in 97.4%, with H. pylori investigation in 58.3%, colonoscopy with quality criteria in 63.6%, and CD screening in 24.7%. Patients with an appropriate study at the time of referral were younger (48.7 ± 17.7 vs 72.3 ± 12.3 years, P < 0.001). Small bowel evaluation was ultimately undertaken in 72.7% of patients, with a more frequent evaluation in patients with a quality colonoscopy at referral (78.6% vs 23.8%); P < 0.001 (OR = 11.7, 95%CI: 3.6-38.6). The most common diagnosis regarded as the likely cause of IDA was small bowel angioectasia (18.2%) but additional causes were also found in the upper and lower gastrointestinal tracts of near 20% of patients. Small bowel studies detected previously unknown non-small bowel findings in 7.7% of patients. CONCLUSIONThe study of anemia prior to referral to gastroenterology department is unsatisfactory. Only approximately a quarter of patients presented with an appropriate study.
基金Supported by Science and Technology Planning Project (ZKHT[2020]-18-4)。
文摘[Objectives]This study was conducted to observe the effect of Lujingyiqishengxue Pill on iron metabolism in rats with iron deficiency anemia. [Methods] The iron-deficiency anemia rat model was established by feeding low-iron diet. Meanwhile, the rats were given oral gavage of ferrous succinate(0.036 g/kg, positive drug group) and Lujingyiqishengxue Pill(4.4, 2.2, 1.1 g/kg, high, middle and low dose groups), once daily for 42 consecutive days. The body weight of the rats was observed every week, and the peripheral blood[red blood cells(RBC), hemoglobin(HGB), and hematocrit(HCT)]and the iron contents in tissues(the liver, spleen, small intestine, kidney) of the rats were detected after modeling;and serum iron(SI), serum total iron binding capacity(TIBC), transferrin saturation(TSAT), serum ferritin(SF) and serum transferrin receptor 1(TFR1) and other iron metabolism indexes were determined. [Results] Compared with the model group, the high-dose Lujingyiqishengxue Pill significantly reversed the peripheral blood(HGB, HCT) and iron contents of various tissues(the liver, spleen, small intestine, kidney) in rats(P<0.01), and significantly increased SI, TSAT, SF(P<0.01), while the contents of TIBC and TFR1 were significantly decreased(P<0.01). [Conclusions] Lujingyiqishengxue Pill can significantly improve anemia and regulate iron metabolism in rats with iron-deficiency anemia, which provides a pharmacological reference for the clinical application of Lujingyiqishengxue Pill.
基金National Natural Science Foundation of China(81774176).
文摘[Objectives]The research aimed to make a retrospective analysis and summary on the efficacy of Jianpi Shengxue Tablet in the treatment of iron deficiency anemia.[Methods]A total of 200 patients with iron deficiency anemia who were treated at outpatient in Tongzhou District of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 1,2017 to October 30,2020 were selected as the research objects.All these patients were given treatment with Jianpi Shengxue Tablet for the first time.Results of blood routine examination,serum iron concentration,total iron binding capacity and ferritin were compared before and after treatment at different dates.Subjective symptoms and adverse reactions were also described.Jianpi Shengxue Tablet was given orally after meals,3 tablets each time,3 times a day.[Results]Hemoglobin level was(83.58±15.81)g/L(M±SD,n=200)before treatment,and(103.40±12.60)g/L(n=74)after 2 week's treatment,with a 24.3%increase(P=0.0047).Hemoglobin concentration was(111.9±19.4)g/L(n=47)at the 4th week after treatment,which was near normality;(126.0±9.49)g/L(n=30)at the 6th week with complete normality and(130.7±7.95)g/L(n=23)at the 8th week.MCV,MCH and MCHC increased gradually after treatment.Serum total iron biding capacity decreased,while serum iron and ferritin increased gradually,and the three indexes were significantly different at the 4th week after treatment as compared with those before treatment(P﹤0.01).Subjective symptoms were improved in the 1st week from starting treatment among all the cases.The adverse events were mainly gastrointestinal irritation,occurring in 7/200 cases(3.5%).[Conclusions]Jianpi Shengxue Tablet is quite effective and safe in the treatment of iron deficiency anemia,with rapid comprehensive improvement of anemia-related symptoms and increase of hemoglobin and red blood cell parameters.
